Provider Demographics
NPI:1467177410
Name:AJADI, CHRISTOPHER AFOLABI (APRN)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:AFOLABI
Last Name:AJADI
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9415 JOWETT PL
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-7585
Mailing Address - Country:US
Mailing Address - Phone:832-630-6014
Mailing Address - Fax:
Practice Address - Street 1:9415 JOWETT PL
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498-7585
Practice Address - Country:US
Practice Address - Phone:832-630-6014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT10743363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty