Provider Demographics
NPI:1033768270
Name:AKANO, OLUSEYI
Entity Type:Individual
Prefix:MRS
First Name:OLUSEYI
Middle Name:
Last Name:AKANO
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 1:3472 BRIDGELAND DR
Mailing Address - Street 2:
Mailing Address - City:BRIDGETON
Mailing Address - State:MO
Mailing Address - Zip Code:63044-2603
Mailing Address - Country:US
Mailing Address - Phone:636-544-1969
Mailing Address - Fax:
Practice Address - Street 1:3472 BRIDGELAND DR
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:MO
Practice Address - Zip Code:63044-2603
Practice Address - Country:US
Practice Address - Phone:636-544-1969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-10
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health