Provider Demographics
NPI:1093106916
Name:AJEPE, OLAYEMI OLUWAKEMI (NP)
Entity Type:Individual
Prefix:
First Name:OLAYEMI
Middle Name:OLUWAKEMI
Last Name:AJEPE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3727
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48106-3727
Mailing Address - Country:US
Mailing Address - Phone:281-866-1614
Mailing Address - Fax:
Practice Address - Street 1:3806 BROKEN PINE CT
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3366
Practice Address - Country:US
Practice Address - Phone:281-866-1614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-13
Last Update Date:2016-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP127155363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily