Provider Demographics
NPI:1629275698
Name:SHITTU, FATIMA ADEYEMI
Entity Type:Individual
Prefix:
First Name:FATIMA
Middle Name:ADEYEMI
Last Name:SHITTU
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 1:1907 SUMMERFIELD PL
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-2555
Mailing Address - Country:US
Mailing Address - Phone:281-494-9366
Mailing Address - Fax:
Practice Address - Street 1:1907 SUMMERFIELD PL
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-2555
Practice Address - Country:US
Practice Address - Phone:281-494-9366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide