Provider Demographics
NPI:1639650856
Name:ARIYIBI, ADETOUN OMOLOLA (RN)
Entity Type:Individual
Prefix:
First Name:ADETOUN
Middle Name:OMOLOLA
Last Name:ARIYIBI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5507 QUARRY RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-4152
Mailing Address - Country:US
Mailing Address - Phone:713-884-9596
Mailing Address - Fax:
Practice Address - Street 1:16320 MELLOW OAKS LN
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498-7214
Practice Address - Country:US
Practice Address - Phone:713-702-6240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-25
Last Update Date:2018-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX847356163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse