Provider Demographics
NPI:1386362432
Name:KAYODE, OLUWATOYIN CHRISTIANA
Entity type:Individual
Prefix:
First Name:OLUWATOYIN
Middle Name:CHRISTIANA
Last Name:KAYODE
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 1:3702 GIBBSTONE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43204-1877
Mailing Address - Country:US
Mailing Address - Phone:201-932-9643
Mailing Address - Fax:
Practice Address - Street 1:3702 GIBBSTONE DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43204-1877
Practice Address - Country:US
Practice Address - Phone:201-932-9643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-16
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN187413164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2615030Medicaid