Provider Demographics
NPI:1730990136
Name:ACQUAYE, OLUKEMI LINDA
Entity type:Individual
Prefix:
First Name:OLUKEMI
Middle Name:LINDA
Last Name:ACQUAYE
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 1:7202 N SHADELAND AVE STE 115
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2031
Mailing Address - Country:US
Mailing Address - Phone:463-294-8144
Mailing Address - Fax:317-429-4440
Practice Address - Street 1:7202 N SHADELAND AVE STE 115
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-2031
Practice Address - Country:US
Practice Address - Phone:463-294-8144
Practice Address - Fax:317-429-4440
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN24-0166643747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider