Provider Demographics
NPI:1528729084
Name:ADESHEKOLA, RUKAYAT ABOLANLE
Entity type:Individual
Prefix:
First Name:RUKAYAT
Middle Name:ABOLANLE
Last Name:ADESHEKOLA
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 1:14016 ROCKBASKET TURN
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23836-9707
Mailing Address - Country:US
Mailing Address - Phone:857-249-4050
Mailing Address - Fax:
Practice Address - Street 1:14016 ROCKBASKET TURN
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23836-9707
Practice Address - Country:US
Practice Address - Phone:857-249-4050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-06
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver