Provider Demographics
NPI:1629654686
Name:ADEYANJU, OLUTOYIN O (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:OLUTOYIN
Middle Name:O
Last Name:ADEYANJU
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:OLUTOYIN
Other - Middle Name:O
Other - Last Name:SOKARI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:651 S LIMESTONE ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45505-1965
Mailing Address - Country:US
Mailing Address - Phone:937-324-1111
Mailing Address - Fax:937-322-3368
Practice Address - Street 1:651 S LIMESTONE ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45505-1965
Practice Address - Country:US
Practice Address - Phone:937-324-1111
Practice Address - Fax:937-322-3368
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-21
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0029979363LP0200X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics