Provider Demographics
NPI:1962667089
Name:ODEDELE, OLUWAFUNKE EVELYN (RN)
Entity type:Individual
Prefix:
First Name:OLUWAFUNKE
Middle Name:EVELYN
Last Name:ODEDELE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:OLUWAFUNKE
Other - Middle Name:EVELYN
Other - Last Name:ADEYALE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:261 CONNECTICUT DR
Mailing Address - Street 2:SUITE 5
Mailing Address - City:BURLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08016-4177
Mailing Address - Country:US
Mailing Address - Phone:609-387-7322
Mailing Address - Fax:609-387-7540
Practice Address - Street 1:261 CONNECTICUT DR
Practice Address - Street 2:SUITE 5
Practice Address - City:BURLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08016-4177
Practice Address - Country:US
Practice Address - Phone:609-387-7322
Practice Address - Fax:609-387-7540
Is Sole Proprietor?:No
Enumeration Date:2008-07-29
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR11294200163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical