Provider Demographics
NPI:1225332158
Name:AKERELE, FUNMILOLA ADENIKE (FNP)
Entity type:Individual
Prefix:
First Name:FUNMILOLA
Middle Name:ADENIKE
Last Name:AKERELE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 BEACH 56TH PL APT 906
Mailing Address - Street 2:
Mailing Address - City:ARVERNE
Mailing Address - State:NY
Mailing Address - Zip Code:11692-1918
Mailing Address - Country:US
Mailing Address - Phone:347-393-5684
Mailing Address - Fax:
Practice Address - Street 1:133 MERIDIAN BLVD
Practice Address - Street 2:
Practice Address - City:ARVERNE
Practice Address - State:NY
Practice Address - Zip Code:11692-2021
Practice Address - Country:US
Practice Address - Phone:347-393-5684
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-06
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY728734163W00000X
NY303999164W00000X
NY357223363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse