1205358298 NPI number — SINMILOLUWA ADELEYE-ONUCHE M.S., M.HR.

Table of content: SINMILOLUWA ADELEYE-ONUCHE M.S., M.HR. (NPI 1205358298)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205358298 NPI number — SINMILOLUWA ADELEYE-ONUCHE M.S., M.HR.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ADELEYE-ONUCHE
Provider First Name:
SINMILOLUWA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.S., M.HR.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ADELEYE
Provider Other First Name:
SINMILOLUWA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1205358298
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/14/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8732 BLOOMFIELD TER
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT WORTH
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76123-4013
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
405-410-5958
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3404 NW 178TH ST STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EDMOND
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73012-9150
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-410-5958
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/11/2017

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  10410 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 101Y00000X , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200764330A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".




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