Provider Demographics
NPI:1235510330
Name:AJAYI, TEMITOPE (MSN, FNP-C)
Entity type:Individual
Prefix:
First Name:TEMITOPE
Middle Name:
Last Name:AJAYI
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10362 OLD OLIVE STREET RD
Mailing Address - Street 2:APT 206
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-5903
Mailing Address - Country:US
Mailing Address - Phone:917-544-1836
Mailing Address - Fax:
Practice Address - Street 1:10362 OLD OLIVE STREET RD
Practice Address - Street 2:APT 206
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-5903
Practice Address - Country:US
Practice Address - Phone:917-544-1836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-15
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016003743363L00000X, 363LF0000X, 363LP2300X
IAA139907363LF0000X, 363LP2300X
TXAP138737363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily