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NPI Code Detail

MEDICARE: SIJUOLA NOIMOT ADELEKAN NP

MEDICARE: SIJUOLA NOIMOT ADELEKAN NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner2005045251MO

General Provider Information

NPI Number : 1184579377
Entity Type Code : Individual
Provider Name (Legal Business Name) : SIJUOLA NOIMOT ADELEKAN NP
Provider Business Mailing Address
First Line : 7 BEHLMANN LAKE CT
Second Line :
City : FLORISSANT
State : MO
Zip : 63034-2862
Country : US
Telephone Number : 314-560-8347
Fax Number :
Provider Business Practice Location Address
First Line : 12303 DE PAUL DR
Second Line :
City : BRIDGETON
State : MO
Zip : 63044-2512
Country : US
Telephone Number : 314-344-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2026
Last Update Date : 03/03/2026

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