Provider Demographics
NPI:1982015806
Name:ADEKUNBI, MORENIKE
Entity Type:Individual
Prefix:
First Name:MORENIKE
Middle Name:
Last Name:ADEKUNBI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 RUNNYMEADE RD
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-6209
Mailing Address - Country:US
Mailing Address - Phone:443-315-9414
Mailing Address - Fax:
Practice Address - Street 1:4701 RUNNYMEADE RD
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-6209
Practice Address - Country:US
Practice Address - Phone:443-315-9414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-13
Last Update Date:2014-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1033043163W00000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse