Provider Demographics
NPI:1023898053
Name:OLATUNJI, KUNLE FRANCIS
Entity type:Individual
Prefix:
First Name:KUNLE
Middle Name:FRANCIS
Last Name:OLATUNJI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2684 HIBISCUS WAY APT 3
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45431-2078
Mailing Address - Country:US
Mailing Address - Phone:937-965-2311
Mailing Address - Fax:
Practice Address - Street 1:2684 HIBISCUS WAY APT 3
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45431-2078
Practice Address - Country:US
Practice Address - Phone:937-965-2311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty