Basic Information
| Provider Information | |||||||||
| NPI: | 1669073029 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ADAMS | ||||||||
| FirstName: | BABATUNDE | ||||||||
| MiddleName: | SAFIRIYU | ||||||||
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| Credential: | CNS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13543 CARLINGFORD WAY | ||||||||
| Address2: | |||||||||
| City: | ROSEMOUNT | ||||||||
| State: | MN | ||||||||
| PostalCode: | 550686306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6514688756 | ||||||||
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| Practice Location | |||||||||
| Address1: | 45 10TH ST W | ||||||||
| Address2: | |||||||||
| City: | SAINT PAUL | ||||||||
| State: | MN | ||||||||
| PostalCode: | 551021062 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6512323000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/03/2020 | ||||||||
| LastUpdateDate: | 11/03/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/29/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 364S00000X | 547 | MN | Y | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist |
No ID Information.