Provider Demographics
NPI:1831631068
Name:MAJEKODUNMI, AMINAT TITILOLA
Entity type:Individual
Prefix:
First Name:AMINAT
Middle Name:TITILOLA
Last Name:MAJEKODUNMI
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 1:7356C SAUERKRAUT LN
Mailing Address - Street 2:
Mailing Address - City:MACUNGIE
Mailing Address - State:PA
Mailing Address - Zip Code:18062-8151
Mailing Address - Country:US
Mailing Address - Phone:708-407-5213
Mailing Address - Fax:
Practice Address - Street 1:7356C SAUERKRAUT LN
Practice Address - Street 2:
Practice Address - City:MACUNGIE
Practice Address - State:PA
Practice Address - Zip Code:18062-8151
Practice Address - Country:US
Practice Address - Phone:708-407-5213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-04
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL043.105304164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse