Provider Demographics
NPI:1679837397
Name:AWOWOYIN, OLUFUNKE OLAROYEKE (LPN)
Entity type:Individual
Prefix:MRS
First Name:OLUFUNKE
Middle Name:OLAROYEKE
Last Name:AWOWOYIN
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 1:3358 ELITE ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-8840
Mailing Address - Country:US
Mailing Address - Phone:614-517-2467
Mailing Address - Fax:
Practice Address - Street 1:3358 ELITE ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-8840
Practice Address - Country:US
Practice Address - Phone:614-517-2467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-27
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH149352164X00000X
OH149352-M-IV164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse