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NPI Code Detail

MEDICARE: JETHRO ADEMOLA

MEDICARE: JETHRO ADEMOLA
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
1164W00000XLicensed Practical NurseLPN1002857DC

General Provider Information

NPI Number : 1578405890
Entity Type Code : Individual
Provider Name (Legal Business Name) : JETHRO ADEMOLA
Provider Business Mailing Address
First Line : 1420 K ST NW STE 1000
Second Line :
City : WASHINGTON
State : DC
Zip : 20005-2508
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1420 K ST NW STE 1000
Second Line :
City : WASHINGTON
State : DC
Zip : 20005-2508
Country : US
Telephone Number : 202-545-6980
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2026
Last Update Date : 04/07/2026

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Directions to “ JETHRO ADEMOLA ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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