Provider Demographics
NPI:1528613429
Name:DUYILEMI, ABIMBOLA OLADUNNI (RN)
Entity type:Individual
Prefix:MRS
First Name:ABIMBOLA
Middle Name:OLADUNNI
Last Name:DUYILEMI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16930 COBBLER CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-7157
Mailing Address - Country:US
Mailing Address - Phone:195-683-2672
Mailing Address - Fax:
Practice Address - Street 1:16930 COBBLER CROSSING DR
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498-7157
Practice Address - Country:US
Practice Address - Phone:195-683-2672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-07
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374U00000X
TX695159163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No374U00000XNursing Service Related ProvidersHome Health Aide