DIVINE FAMILY PRACTICE AND URGENT CARE PLLC NPI 1548881279

NPI Information

DIVINE FAMILY PRACTICE AND URGENT CARE, PLLC is a primary care nurse practitioner in Fayetteville, NC. DIVINE FAMILY PRACTICE AND URGENT CARE, PLLC NPI is 1548881279. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3616 CAPE CENTER DR
FAYETTEVILLE, NC
ZIP 28304-456
Phone: (910) 900-8294
Fax: (910) 900-8280

The provider's authorized official is Abimbola A Ogunleye-kolawole .
The authorized official title is Dnp, Fnp-bc and has the following contact phone number (910) 900-8294.

The CLIA number assigned to this NPI record is 34D2176929 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/5/2020 and was last updated on 8/30/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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