Provider Demographics
NPI:1316325079
Name:AYODEJI, ABOUNDE
Entity type:Individual
Prefix:
First Name:ABOUNDE
Middle Name:
Last Name:AYODEJI
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 1:6856 EASTERN AVE NW
Mailing Address - Street 2:SUITE 320A
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20012-2165
Mailing Address - Country:US
Mailing Address - Phone:202-541-9844
Mailing Address - Fax:202-541-9845
Practice Address - Street 1:6856 EASTERN AVE NW
Practice Address - Street 2:SUITE 320A
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-2165
Practice Address - Country:US
Practice Address - Phone:202-541-9844
Practice Address - Fax:202-541-9845
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-14
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374U00000X
DCRN1047176163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No374U00000XNursing Service Related ProvidersHome Health Aide