Provider Demographics
NPI:1669073029
Name:ADAMS, BABATUNDE SAFIRIYU (CNS, CNP)
Entity type:Individual
Prefix:
First Name:BABATUNDE
Middle Name:SAFIRIYU
Last Name:ADAMS
Suffix:
Gender:M
Credentials:CNS, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13543 CARLINGFORD WAY
Mailing Address - Street 2:
Mailing Address - City:ROSEMOUNT
Mailing Address - State:MN
Mailing Address - Zip Code:55068-6306
Mailing Address - Country:US
Mailing Address - Phone:651-468-8756
Mailing Address - Fax:
Practice Address - Street 1:525, 23RD AVE. SOUTH
Practice Address - Street 2:NORTH BUILDING
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454
Practice Address - Country:US
Practice Address - Phone:651-232-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-03
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN547364S00000X
MN11078363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist