Provider Demographics
NPI:1992919070
Name:ADELIYI, BIOLA LEANN (LPN)
Entity type:Individual
Prefix:
First Name:BIOLA
Middle Name:LEANN
Last Name:ADELIYI
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6699 CONCOURSE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-1432
Mailing Address - Country:US
Mailing Address - Phone:614-882-0524
Mailing Address - Fax:
Practice Address - Street 1:6699 CONCOURSE DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-1432
Practice Address - Country:US
Practice Address - Phone:614-882-0524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 125017164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHPN125017OtherLPN