Provider Demographics
NPI:1891983409
Name:ODIGIE, ADEFOLUKE ADENIKE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:ADEFOLUKE
Middle Name:ADENIKE
Last Name:ODIGIE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4683 ASCOT DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-5776
Mailing Address - Country:US
Mailing Address - Phone:614-840-9091
Mailing Address - Fax:
Practice Address - Street 1:4683 ASCOT DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-5776
Practice Address - Country:US
Practice Address - Phone:614-840-9091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 125695164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse