Provider Demographics
NPI:1205454956
Name:CHRIS-ROTIMI, ADELANKE (NP)
Entity type:Individual
Prefix:
First Name:ADELANKE
Middle Name:
Last Name:CHRIS-ROTIMI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 W GRAND PKWY S STE M
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-8331
Mailing Address - Country:US
Mailing Address - Phone:281-916-1444
Mailing Address - Fax:
Practice Address - Street 1:5 CLAY ST
Practice Address - Street 2:
Practice Address - City:MALONE
Practice Address - State:NY
Practice Address - Zip Code:12953-1905
Practice Address - Country:US
Practice Address - Phone:518-483-0705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-09
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP145405363LF0000X
NY355635363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily