Basic Information
| Provider Information | |||||||||
| NPI: | 1154545911 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AYORINDE | ||||||||
| FirstName: | ETHEL | ||||||||
| MiddleName: | EGBUA | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | R.N. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 28939 LAKE PARK DR | ||||||||
| Address2: | |||||||||
| City: | FARMINGTON HILLS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483312634 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2483243737 | ||||||||
| FaxNumber: | 7343265843 | ||||||||
| Practice Location | |||||||||
| Address1: | 35555 GARFIELD RD | ||||||||
| Address2: | 3B | ||||||||
| City: | CLINTON TOWNSHIP | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480355517 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5867921654 | ||||||||
| FaxNumber: | 5867921656 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | L850571 | MI | Y | Nursing Service Providers | Registered Nurse |
No ID Information.