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General NPI Number Information
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NPI Number | 1205454956
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Entity Type | Individual
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Provider Name | ADELANKE CHRIS-ROTIMI NP
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Gender | Female
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Dates
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Enumeration Date | 07/09/2020
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Last Update Date | 06/06/2025
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Provider Practice Location Address
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Address Line | 5 CLAY ST
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City | MALONE
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State | NY
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Zip | 12953-1905
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Country | US
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Telephone | 518-483-0705
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Fax |
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Provider Business Mailing Address
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Address Line | 1450 W GRAND PKWY S STE M
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City | KATY
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State | TX
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Zip | 77494-8331
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Country | US
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Telephone | 281-916-1444
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP145405
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 355635
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License Number State | NY
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