Provider Demographics
NPI:1356638530
Name:OGUNTUYI, CHRISTIANAH OLAJUMOKE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTIANAH
Middle Name:OLAJUMOKE
Last Name:OGUNTUYI
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2518 DEXHAM CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43224-3757
Mailing Address - Country:US
Mailing Address - Phone:614-822-0043
Mailing Address - Fax:
Practice Address - Street 1:2518 DEXHAM CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43224-3757
Practice Address - Country:US
Practice Address - Phone:614-822-0043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-07
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN144071-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse