Individual
DEISHA DASHANE HAYE-TINUOLAJI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7950 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4140
(260) 435-7302
Mailing address
7950 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4140
(260) 435-7302
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28242205A
IN
363L00000X
Nurse Practitioner
Primary
28242205A
IN
Other
Enumeration date
11/08/2024
Last updated
12/23/2024
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