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General NPI Number Information
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NPI Number | 1093178568
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Entity Type | Individual
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Provider Name | JENDAYI OLABISI M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/01/2016
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Last Update Date | 12/07/2025
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Provider Practice Location Address
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Address Line | 1060 E 86TH ST STE 65E
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City | INDIANAPOLIS
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State | IN
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Zip | 46240-1831
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Country | US
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Telephone | 173-572-5242
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 917770
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City | ORLANDO
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State | FL
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Zip | 32891-0001
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Country | US
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Telephone | 813-821-8038
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME150017
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 01081065A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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