Healthcare Provider Details

I. General information

NPI: 1881524056
Provider Name (Legal Business Name): FUNMILAYO OLUBAYO UJIMA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 S 11TH AVE W LOT 20
DICKINSON ND
58601-4868
US

IV. Provider business mailing address

66 S 11TH AVE W LOT 20
DICKINSON ND
58601-4868
US

V. Phone/Fax

Practice location:
  • Phone: 701-690-4455
  • Fax:
Mailing address:
  • Phone: 701-690-4455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: