Provider Demographics
NPI:1871034777
Name:AYANBADEJO, MARIE FRANCOISE FAYE (FNP-C,)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:FRANCOISE FAYE
Last Name:AYANBADEJO
Suffix:
Gender:F
Credentials:FNP-C,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10360 AUTRY PL
Mailing Address - Street 2:
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30022-5301
Mailing Address - Country:US
Mailing Address - Phone:404-793-9444
Mailing Address - Fax:
Practice Address - Street 1:10360 AUTRY PL
Practice Address - Street 2:
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30022-5301
Practice Address - Country:US
Practice Address - Phone:404-793-9444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-13
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN229261363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care