Provider Demographics
NPI:1053624783
Name:OGUNSEYIN, IDOWU OLAMIDE (LPN)
Entity type:Individual
Prefix:
First Name:IDOWU
Middle Name:OLAMIDE
Last Name:OGUNSEYIN
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 1:5732 PINE TREE ST W
Mailing Address - Street 2:APT.K
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-3789
Mailing Address - Country:US
Mailing Address - Phone:614-806-9087
Mailing Address - Fax:
Practice Address - Street 1:5732 PINE TREE ST W
Practice Address - Street 2:APT.K
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-3789
Practice Address - Country:US
Practice Address - Phone:614-806-9087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-22
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN: 131564164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse