Provider Demographics
NPI:1437994555
Name:FIMIHAN-AJAYI, FLORENCE IYABO
Entity type:Individual
Prefix:
First Name:FLORENCE
Middle Name:IYABO
Last Name:FIMIHAN-AJAYI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 ALYDAR DR
Mailing Address - Street 2:
Mailing Address - City:NORTH LIBERTY
Mailing Address - State:IA
Mailing Address - Zip Code:52317-4755
Mailing Address - Country:US
Mailing Address - Phone:773-615-5574
Mailing Address - Fax:
Practice Address - Street 1:115 ALYDAR DR
Practice Address - Street 2:
Practice Address - City:NORTH LIBERTY
Practice Address - State:IA
Practice Address - Zip Code:52317-4755
Practice Address - Country:US
Practice Address - Phone:773-615-5574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-29
Last Update Date:2024-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA179828363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily