Healthcare Provider Details

I. General information

NPI: 1942990874
Provider Name (Legal Business Name): LINDA OLOYEDE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2023
Last Update Date: 06/06/2024
Certification Date: 06/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4317 13TH AVE NW
ROCHESTER MN
55901-8273
US

IV. Provider business mailing address

1500 1ST AVE NE STE 110
ROCHESTER MN
55906-4170
US

V. Phone/Fax

Practice location:
  • Phone: 507-271-8862
  • Fax:
Mailing address:
  • Phone: 507-258-4335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number411848
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: