Provider Demographics
NPI:1205722188
Name:OGUNBANWO, ADENIKE S (RN)
Entity type:Individual
Prefix:
First Name:ADENIKE
Middle Name:S
Last Name:OGUNBANWO
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 1:5501 88TH CRES N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55443-3983
Mailing Address - Country:US
Mailing Address - Phone:763-568-6204
Mailing Address - Fax:612-444-7501
Practice Address - Street 1:5501 88TH CRES N
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55443-3983
Practice Address - Country:US
Practice Address - Phone:763-568-6204
Practice Address - Fax:612-444-7501
Is Sole Proprietor?:No
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN2285292163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health