Provider Demographics
NPI:1598656969
Name:ADETORO, EUNICE AYOBAMI
Entity type:Individual
Prefix:
First Name:EUNICE
Middle Name:AYOBAMI
Last Name:ADETORO
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 1:7412 WHIPPORWILL PL APT F
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-3669
Mailing Address - Country:US
Mailing Address - Phone:682-256-2951
Mailing Address - Fax:
Practice Address - Street 1:5435 E 16TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46218-4869
Practice Address - Country:US
Practice Address - Phone:317-941-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28263899A163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse