Provider Demographics
NPI:1497477665
Name:AGBAJE, HELEN
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:
Last Name:AGBAJE
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 1:5745 N HILLBROOKE TRCE
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-7299
Mailing Address - Country:US
Mailing Address - Phone:404-421-5786
Mailing Address - Fax:
Practice Address - Street 1:5745 N HILLBROOKE TRCE
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-7299
Practice Address - Country:US
Practice Address - Phone:404-421-5786
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-14
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN232228163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant