Provider Demographics
NPI:1083236087
Name:APATA, ADENIKE ANNE (RN)
Entity Type:Individual
Prefix:
First Name:ADENIKE
Middle Name:ANNE
Last Name:APATA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3796 OKEFENOKEE RDG
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-7167
Mailing Address - Country:US
Mailing Address - Phone:404-287-8353
Mailing Address - Fax:
Practice Address - Street 1:3796 OKEFENOKEE RDG
Practice Address - Street 2:
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-7167
Practice Address - Country:US
Practice Address - Phone:404-287-8353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-12
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN250863163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health