Provider Demographics
NPI:1013809342
Name:BISIRIYU, YETUNDE A
Entity type:Individual
Prefix:
First Name:YETUNDE
Middle Name:A
Last Name:BISIRIYU
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 1:4337 POPLAR VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-4814
Mailing Address - Country:US
Mailing Address - Phone:804-637-0307
Mailing Address - Fax:804-637-0307
Practice Address - Street 1:4337 POPLAR VILLAGE DR
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-4814
Practice Address - Country:US
Practice Address - Phone:804-637-0307
Practice Address - Fax:804-637-0307
Is Sole Proprietor?:No
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide