Healthcare Provider Details

I. General information

NPI: 1508734278
Provider Name (Legal Business Name): OLUWASEYI ROSELINE ADENIJI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2025
Last Update Date: 10/25/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

504 ALMERE DR
HAMPTON GA
30228-3817
US

IV. Provider business mailing address

504 ALMERE DR
HAMPTON GA
30228-3817
US

V. Phone/Fax

Practice location:
  • Phone: 404-322-5873
  • Fax:
Mailing address:
  • Phone: 404-322-5873
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN304468
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: