Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Olufemi Olawale Fanusi

Individual provider Family Nurse Practitioner · NPI 1003561705

Mr. Olufemi Olawale Fanusi is a Nurse Practitioner in Stonecrest, Georgia. Qualified in 2021, 5 years ago. Practices with Pruitthealth Hospice Inc, a 40-clinician group. Licensed in Georgia.

Years since qualifying
5
Licensed in
GA
In the registry since
2022
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Practice location Address checks out

4202 Kensington Cir
Stonecrest, GA 30038-3239
Phone: (678) 680-9209
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence RN285470 (GA)

Record details

NPI number1003561705
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedFebruary 21, 2022
Last updated in NPPESFebruary 21, 2022
Certification dateFebruary 21, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Pruitthealth Hospice Inc — 40 clinicians
Accepts Medicare assignment Not indicated

Colleagues at Pruitthealth Hospice Inc

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 40 clinicians in the practice; 12 are shown here.

Other providers in Stonecrest