Provider Demographics
NPI:1386027589
Name:OYEBODE, OLAJUMOKE OLUWASEUN
Entity Type:Individual
Prefix:MRS
First Name:OLAJUMOKE
Middle Name:OLUWASEUN
Last Name:OYEBODE
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 1:11010 LOCHRANZA LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-1547
Mailing Address - Country:US
Mailing Address - Phone:612-414-4721
Mailing Address - Fax:
Practice Address - Street 1:11010 LOCHRANZA LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-1547
Practice Address - Country:US
Practice Address - Phone:612-414-4721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-07
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No374U00000XNursing Service Related ProvidersHome Health Aide
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant