Healthcare Provider Details

I. General information

NPI: 1215854922
Provider Name (Legal Business Name): RUKAYAT ORIRE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RUKAYAT MUSTAPHA

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6010 SYCAMORE FORGE LN
INDIANAPOLIS IN
46254-1293
US

IV. Provider business mailing address

6010 SYCAMORE FORGE LN
INDIANAPOLIS IN
46254-1293
US

V. Phone/Fax

Practice location:
  • Phone: 623-235-1845
  • Fax:
Mailing address:
  • Phone: 623-235-1845
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number260203901
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: