Provider Demographics
NPI:1093531907
Name:OLANREWAJU, YEWANDE OLAJUMOKE
Entity type:Individual
Prefix:MRS
First Name:YEWANDE
Middle Name:OLAJUMOKE
Last Name:OLANREWAJU
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 1:7775 TERRI DR
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-9449
Mailing Address - Country:US
Mailing Address - Phone:734-444-6492
Mailing Address - Fax:
Practice Address - Street 1:7775 TERRI DR
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-9449
Practice Address - Country:US
Practice Address - Phone:734-444-6492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No372600000XNursing Service Related ProvidersAdult Companion