Provider Demographics
NPI:1043350598
Name:ADEYANJU, ABAYOMI OLUSEGUN (LPN)
Entity Type:Individual
Prefix:MR
First Name:ABAYOMI
Middle Name:OLUSEGUN
Last Name:ADEYANJU
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 CHRISTIANA RD APT I17
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-2950
Mailing Address - Country:US
Mailing Address - Phone:302-328-5124
Mailing Address - Fax:
Practice Address - Street 1:260 CHRISTIANA RD APT I17
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-2950
Practice Address - Country:US
Practice Address - Phone:302-328-5124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL2-0009478164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse