Provider Demographics
NPI:1508651043
Name:FABAYO, ADERONKE I
Entity type:Individual
Prefix:
First Name:ADERONKE
Middle Name:I
Last Name:FABAYO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9250 BRATTON CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46234-1680
Mailing Address - Country:US
Mailing Address - Phone:317-489-2859
Mailing Address - Fax:317-932-8076
Practice Address - Street 1:5724 GREEN ST # 246
Practice Address - Street 2:
Practice Address - City:BROWNSBURG
Practice Address - State:IN
Practice Address - Zip Code:46112-1471
Practice Address - Country:US
Practice Address - Phone:317-489-2859
Practice Address - Fax:317-932-8076
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care