Provider Demographics
NPI:1790268548
Name:ALALADE, ABIOLA O (NP)
Entity Type:Individual
Prefix:
First Name:ABIOLA
Middle Name:O
Last Name:ALALADE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ABIOLA
Other - Middle Name:O
Other - Last Name:MAFOLASIRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:99 E CARMEL DR STE 150
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-2400
Mailing Address - Country:US
Mailing Address - Phone:317-963-1616
Mailing Address - Fax:317-963-1621
Practice Address - Street 1:99 E CARMEL DR STE 150
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-2400
Practice Address - Country:US
Practice Address - Phone:317-963-1616
Practice Address - Fax:317-963-1621
Is Sole Proprietor?:No
Enumeration Date:2018-09-07
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71008286A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily