Provider Demographics
NPI:1083268965
Name:ADEDURO, ADERONKE EVELYN
Entity Type:Individual
Prefix:
First Name:ADERONKE EVELYN
Middle Name:
Last Name:ADEDURO
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 1:6511 100TH AVE
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2645
Mailing Address - Country:US
Mailing Address - Phone:301-237-5664
Mailing Address - Fax:
Practice Address - Street 1:6511 100TH AVE
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2645
Practice Address - Country:US
Practice Address - Phone:301-237-5664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-29
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLPN7923164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse