Provider Demographics
NPI:1457816092
Name:AKINROLABU, ADEDAYO
Entity Type:Individual
Prefix:
First Name:ADEDAYO
Middle Name:
Last Name:AKINROLABU
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 1:5903 EAGLES CROSSING LN
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30274-1434
Mailing Address - Country:US
Mailing Address - Phone:404-993-9211
Mailing Address - Fax:770-907-7916
Practice Address - Street 1:5903 EAGLES CROSSING LN
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:GA
Practice Address - Zip Code:30274-1434
Practice Address - Country:US
Practice Address - Phone:404-993-9211
Practice Address - Fax:770-907-7916
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-07
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN238279374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide