Provider Demographics
NPI:1386121481
Name:ADEKOYA MAKINDE, OLUFUFNMILAYO ELIZABETH
Entity type:Individual
Prefix:
First Name:OLUFUFNMILAYO
Middle Name:ELIZABETH
Last Name:ADEKOYA MAKINDE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:FUNMILAYO
Other - Middle Name:ELIZABETH
Other - Last Name:ADEKOYA MAKINDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3560 COUNTRY SQUARE DR APT 411
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-6751
Mailing Address - Country:US
Mailing Address - Phone:678-600-0770
Mailing Address - Fax:
Practice Address - Street 1:3560 COUNTRY SQUARE DR APT 411
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-6751
Practice Address - Country:US
Practice Address - Phone:678-600-0770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-23
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN208332163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse