Samson Ajibola Omowumi
Samson Ajibola Omowumi is a Psychiatric/Mental Health Nurse Practitioner in Peoria, Illinois. Practices as a sole proprietor. Licensed in Illinois.
- Licensed in
- IL
- In the registry since
- 2024
Practice location Address checks out
5401 N Knoxville AvePeoria, IL 61614-5098
Phone: (614) 816-7589
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Psychiatric/Mental Health Nurse Practitioner (primary) | Taxonomy 363LP0808X · Licence 209.030167 (IL) |
|---|
Record details
| NPI number | 1457181877 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | August 2, 2024 |
| Last updated in NPPES | August 2, 2024 |
| Certification date | August 2, 2024 |
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