Provider Demographics
NPI:1245905397
Name:AYANGADE, OLUWATOYIN O (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:OLUWATOYIN
Middle Name:O
Last Name:AYANGADE
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9917 COYOTE PASS TRL
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-6548
Mailing Address - Country:US
Mailing Address - Phone:219-299-1652
Mailing Address - Fax:
Practice Address - Street 1:9917 COYOTE PASS TRL
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-6548
Practice Address - Country:US
Practice Address - Phone:219-299-1652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-11
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
TX171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator