Provider Demographics
NPI:1750728382
Name:AKINDELE, TUNDE ABASS (LPN)
Entity type:Individual
Prefix:MR
First Name:TUNDE
Middle Name:ABASS
Last Name:AKINDELE
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12408 HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-1852
Mailing Address - Country:US
Mailing Address - Phone:810-624-2170
Mailing Address - Fax:
Practice Address - Street 1:12408 HILLCREST DR
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-1852
Practice Address - Country:US
Practice Address - Phone:810-624-2170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-22
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703103826164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse