1760116735 NPI number — MRS. OLAKIITAN EUNICE AYODELE CASE MANAGER 11

Table of content: MRS. OLAKIITAN EUNICE AYODELE CASE MANAGER 11 (NPI 1760116735)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760116735 NPI number — MRS. OLAKIITAN EUNICE AYODELE CASE MANAGER 11

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AYODELE
Provider First Name:
OLAKIITAN
Provider Middle Name:
EUNICE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CASE MANAGER 11
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
AYODELE
Provider Other First Name:
OLAKIITAN
Provider Other Middle Name:
EUNICE
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
OJO OLAKIITAN EUNICE
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1760116735
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/14/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2630 EAST 88TH STREET,APT.4
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TULSA
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
74137
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
918-344-3931
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2630 E 88TH ST APT 4
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TULSA
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74137-1129
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
918-344-3931
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/14/2022

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: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YS0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TF0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 106H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225C00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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