Provider Demographics
NPI:1336440304
Name:ADELAJA, OLUBUNMI
Entity Type:Individual
Prefix:
First Name:OLUBUNMI
Middle Name:
Last Name:ADELAJA
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 1:6951 LAUREL BOAT LN
Mailing Address - Street 2:
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110-7835
Mailing Address - Country:US
Mailing Address - Phone:614-805-1966
Mailing Address - Fax:
Practice Address - Street 1:6951 LAUREL BOAT LN
Practice Address - Street 2:
Practice Address - City:CANAL WINCHESTER
Practice Address - State:OH
Practice Address - Zip Code:43110-7835
Practice Address - Country:US
Practice Address - Phone:614-805-1966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-08
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN. 365513163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse