Provider Demographics
NPI:1083365563
Name:YUSSUF, AJOKE ADERAYO
Entity Type:Individual
Prefix:
First Name:AJOKE
Middle Name:ADERAYO
Last Name:YUSSUF
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 1:1136 N WHITCOMB AVE APT C
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46224-6718
Mailing Address - Country:US
Mailing Address - Phone:240-484-0418
Mailing Address - Fax:
Practice Address - Street 1:1136 N WHITCOMB AVE APT C
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46224-6718
Practice Address - Country:US
Practice Address - Phone:240-484-0418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-16
Last Update Date:2022-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider