Provider Demographics
NPI:1821392283
Name:ADU, FOLORUNSO M (LPN)
Entity Type:Individual
Prefix:MR
First Name:FOLORUNSO
Middle Name:M
Last Name:ADU
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:887 PRINCE WILLIAM LN
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-1925
Mailing Address - Country:US
Mailing Address - Phone:614-257-8184
Mailing Address - Fax:
Practice Address - Street 1:887 PRINCE WILLIAM LN
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-1925
Practice Address - Country:US
Practice Address - Phone:614-257-8184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-28
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN125841164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse