Healthcare Provider Details

I. General information

NPI: 1487509097
Provider Name (Legal Business Name): KELVIN TUNDE ODAJI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2026
Last Update Date: 02/27/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 WELLINGTON PL UNIT A115
CINCINNATI OH
45219-4015
US

IV. Provider business mailing address

141 WELLINGTON PL UNIT A115
CINCINNATI OH
45219-4015
US

V. Phone/Fax

Practice location:
  • Phone: 469-901-1667
  • Fax:
Mailing address:
  • Phone: 469-901-1667
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0041261
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: