Provider Demographics
NPI:1902674039
Name:OLAOLUWA, ADENIKE
Entity Type:Individual
Prefix:MRS
First Name:ADENIKE
Middle Name:
Last Name:OLAOLUWA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5901 BUCK ST
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-1296
Mailing Address - Country:US
Mailing Address - Phone:734-643-2551
Mailing Address - Fax:
Practice Address - Street 1:5901 BUCK ST
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-1296
Practice Address - Country:US
Practice Address - Phone:734-643-2551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider