Provider Demographics
NPI:1912727868
Name:KALEJAYE, DUNNI OMOLOLA
Entity type:Individual
Prefix:
First Name:DUNNI
Middle Name:OMOLOLA
Last Name:KALEJAYE
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 1:19162 IVANHOE DR NW
Mailing Address - Street 2:
Mailing Address - City:ELK RIVER
Mailing Address - State:MN
Mailing Address - Zip Code:55330-5077
Mailing Address - Country:US
Mailing Address - Phone:763-291-4028
Mailing Address - Fax:
Practice Address - Street 1:19162 IVANHOE DR NW
Practice Address - Street 2:
Practice Address - City:ELK RIVER
Practice Address - State:MN
Practice Address - Zip Code:55330-5077
Practice Address - Country:US
Practice Address - Phone:763-291-4028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-15
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2507275163WP0808X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health