Provider Demographics
NPI:1174814289
Name:AJAYI, IJEOMA CHRISTIANA (RN , BSN,MSN,FNP-C)
Entity Type:Individual
Prefix:
First Name:IJEOMA
Middle Name:CHRISTIANA
Last Name:AJAYI
Suffix:
Gender:F
Credentials:RN , BSN,MSN,FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 E CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-6331
Mailing Address - Country:US
Mailing Address - Phone:559-737-4700
Mailing Address - Fax:559-734-1247
Practice Address - Street 1:263 S WEST ST
Practice Address - Street 2:
Practice Address - City:TULARE
Practice Address - State:CA
Practice Address - Zip Code:93274-3411
Practice Address - Country:US
Practice Address - Phone:877-960-3426
Practice Address - Fax:559-741-8414
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-22
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP127415363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily