Provider Demographics
NPI:1609139088
Name:AKINDIPE, ADERONKE A (FNP)
Entity Type:Individual
Prefix:
First Name:ADERONKE
Middle Name:A
Last Name:AKINDIPE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ADERONKE
Other - Middle Name:A
Other - Last Name:OLUBUMMO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 4105
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208-4105
Mailing Address - Country:US
Mailing Address - Phone:866-907-1068
Mailing Address - Fax:425-917-9141
Practice Address - Street 1:910 COMPASSION CIR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-1645
Practice Address - Country:US
Practice Address - Phone:907-212-9200
Practice Address - Fax:907-212-9283
Is Sole Proprietor?:No
Enumeration Date:2012-06-20
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK34281163W00000X
AK119128363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse