Provider Demographics
NPI:1871963678
Name:ADEWUYI, FALASHADE F (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:FALASHADE
Middle Name:F
Last Name:ADEWUYI
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:386 STANLEY ST
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-6009
Mailing Address - Country:US
Mailing Address - Phone:508-679-5222
Mailing Address - Fax:
Practice Address - Street 1:1 RICHMOND SQ STE 321W
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-5156
Practice Address - Country:US
Practice Address - Phone:401-401-1300
Practice Address - Fax:401-633-6416
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-06
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN275164363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health