Provider Demographics
NPI:1679135917
Name:ABOLARINWA, CHRISTIANAH FUNKE
Entity Type:Individual
Prefix:
First Name:CHRISTIANAH
Middle Name:FUNKE
Last Name:ABOLARINWA
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 1:3104 BRUCE PL SE APT 401
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-2951
Mailing Address - Country:US
Mailing Address - Phone:240-302-4409
Mailing Address - Fax:
Practice Address - Street 1:3104 BRUCE PL SE APT 401
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-2951
Practice Address - Country:US
Practice Address - Phone:240-302-4409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-08
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA14549374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide