Provider Demographics
NPI:1861971400
Name:ADEBAYO, YEMISI DAMILOLA
Entity type:Individual
Prefix:
First Name:YEMISI
Middle Name:DAMILOLA
Last Name:ADEBAYO
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 1:13101 BRIAR FOREST DR APT 6612
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-2016
Mailing Address - Country:US
Mailing Address - Phone:832-406-0388
Mailing Address - Fax:
Practice Address - Street 1:13101 BRIAR FOREST DR APT 6612
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-2016
Practice Address - Country:US
Practice Address - Phone:832-406-0388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-13
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX899482163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse