Provider Demographics
NPI:1548063621
Name:AJALA, ADEOLA OLAITAN (NP)
Entity type:Individual
Prefix:
First Name:ADEOLA
Middle Name:OLAITAN
Last Name:AJALA
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 1:4352 S HIMALAYA CIR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015-5468
Mailing Address - Country:US
Mailing Address - Phone:720-388-4174
Mailing Address - Fax:
Practice Address - Street 1:19557 E 39TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80249-7347
Practice Address - Country:US
Practice Address - Phone:720-400-2706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.1000695-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty