Provider Demographics
NPI:1508572702
Name:ADEYI, JULIE O
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:O
Last Name:ADEYI
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 1:3829 BRENTWOOD RD APT J
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-1775
Mailing Address - Country:US
Mailing Address - Phone:347-595-4122
Mailing Address - Fax:919-989-8015
Practice Address - Street 1:105 PRIMROSE LN
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-5634
Practice Address - Country:US
Practice Address - Phone:919-989-8015
Practice Address - Fax:919-989-8015
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty