Provider Demographics
NPI:1528837267
Name:ADEBAYO, MARIKA D (LPN)
Entity type:Individual
Prefix:
First Name:MARIKA
Middle Name:D
Last Name:ADEBAYO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6201 JOHNSON DR APT 505
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66202-3483
Mailing Address - Country:US
Mailing Address - Phone:816-389-9546
Mailing Address - Fax:
Practice Address - Street 1:6201 JOHNSON DR APT 505
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:KS
Practice Address - Zip Code:66202-3483
Practice Address - Country:US
Practice Address - Phone:816-389-9546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-21
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS24857144164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse