Provider Demographics
NPI:1891288056
Name:AKINSUYI, AYODELE BOLATITO (NP)
Entity Type:Individual
Prefix:MRS
First Name:AYODELE
Middle Name:BOLATITO
Last Name:AKINSUYI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11287 FEATHERHILL LN
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-4873
Mailing Address - Country:US
Mailing Address - Phone:757-581-4296
Mailing Address - Fax:
Practice Address - Street 1:11287 FEATHERHILL LN
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-4873
Practice Address - Country:US
Practice Address - Phone:757-581-4296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-12
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95008840363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health