Provider Demographics
NPI:1306722111
Name:AINA, OLUBUNMI TOPE (PMHNP)
Entity type:Individual
Prefix:MRS
First Name:OLUBUNMI
Middle Name:TOPE
Last Name:AINA
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1916 CANYON LIVE OAK ST
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-3286
Mailing Address - Country:US
Mailing Address - Phone:856-536-7192
Mailing Address - Fax:
Practice Address - Street 1:1916 CANYON LIVE OAK ST
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-3286
Practice Address - Country:US
Practice Address - Phone:856-536-7192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-15
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1029174363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health