Provider Demographics
NPI:1952109076
Name:AYEDUN, CHRISTIANAH OLUKEMI (BSN, RN)
Entity type:Individual
Prefix:
First Name:CHRISTIANAH
Middle Name:OLUKEMI
Last Name:AYEDUN
Suffix:
Gender:
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6603 AVENUE N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-5713
Mailing Address - Country:US
Mailing Address - Phone:718-908-8015
Mailing Address - Fax:
Practice Address - Street 1:6603 AVENUE N
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-5713
Practice Address - Country:US
Practice Address - Phone:718-908-8015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY722226163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice