Provider Demographics
NPI:1215155882
Name:MAKANJUOLA, JOHN ABAYOMI (RN)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:ABAYOMI
Last Name:MAKANJUOLA
Suffix:
Gender:M
Credentials:RN
Other - Prefix:MR
Other - First Name:JOHN
Other - Middle Name:
Other - Last Name:MAKANJUOLA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:953 LAKETREE CT W
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-1930
Mailing Address - Country:US
Mailing Address - Phone:614-899-0547
Mailing Address - Fax:
Practice Address - Street 1:953 LAKETREE CT W
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-1930
Practice Address - Country:US
Practice Address - Phone:614-899-0547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH330710163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse