Doctor Name: | ADEBOLA O ADELEYE |
NPI Number: | 1033417555 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APN-C |
License Number: | 26NJ00317000 |
Business Practice Address: | 2003 Davidsonville Rd Cvs Minute Clinic Crofton, MD - 211141317 |
Business Phone Number: | 8663892727 |
Business Fax Number: | |
Mailing Address: | 1 Cvs Dr, Attn: Minuteclinic Credentialing 2100 WOONSOCKET |
State: | RI |
Postal Code: | 028956146 |
Phone Number: | 8663892727 |
Fax Number: | 4016529787 |
NPI Enumeration Date: | 03/08/2011 |
NPI Last Update Date: | 07/27/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 26NJ00317000 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NJ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |