Provider Demographics
NPI:1912496639
Name:ADEBAYO, BEATRICE ADETOUN (RN)
Entity Type:Individual
Prefix:
First Name:BEATRICE
Middle Name:ADETOUN
Last Name:ADEBAYO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 MAGIC DR APT 168
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-2941
Mailing Address - Country:US
Mailing Address - Phone:210-810-8552
Mailing Address - Fax:
Practice Address - Street 1:3400 MAGIC DR APT 168
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-2941
Practice Address - Country:US
Practice Address - Phone:210-810-8552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-08
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX775800163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health