Provider Demographics
NPI:1356697247
Name:IKHILE, OLAYEMI (FNP)
Entity type:Individual
Prefix:
First Name:OLAYEMI
Middle Name:
Last Name:IKHILE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 JAMES MADISON HWY
Mailing Address - Street 2:SUITE 104
Mailing Address - City:CULPEPER
Mailing Address - State:VA
Mailing Address - Zip Code:22701-2360
Mailing Address - Country:US
Mailing Address - Phone:540-727-8880
Mailing Address - Fax:540-727-8882
Practice Address - Street 1:1200 EDWARDS FERRY RD NE
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-3318
Practice Address - Country:US
Practice Address - Phone:703-777-8730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-28
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001228146163W00000X
VA0024170210363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse