Provider Demographics
NPI:1780224865
Name:DAODU, NUSIRAT
Entity Type:Individual
Prefix:
First Name:NUSIRAT
Middle Name:
Last Name:DAODU
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 1:124 MARRIOTT DR STE 104
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-2981
Mailing Address - Country:US
Mailing Address - Phone:850-391-0031
Mailing Address - Fax:
Practice Address - Street 1:124 MARRIOTT DR STE 104
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-2981
Practice Address - Country:US
Practice Address - Phone:850-391-0031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-07
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No172V00000XOther Service ProvidersCommunity Health Worker