Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Shiyanbola Ajao

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1790363653

Shiyanbola Ajao is a Nurse Practitioner in Union, New Jersey. Qualified in 2021, 5 years ago. Practices with Grady Memorial Hospital Corporation, a 363-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Georgia, New Jersey, Oregon and Washington.

Years since qualifying
5
Licensed in
GA, NJ, OR, WA
In the registry since
2021
Specialties on file
5

Practice location Address checks out

540 N Ave # 2036
Union, NJ 07083-7148
Phone: (912) 844-3313
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1800 Phoenix Blvd Ste 128-12, Atlanta, GA 30349-5593 — (678) 525-7787

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 26NJ14933300 (NJ)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence 10009869 (OR)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence AP61395314 (WA)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence RN263471 (GA)
Registered Nurse Taxonomy 163W00000X · Licence RN263471 (GA)

Record details

NPI number1790363653
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMarch 31, 2021
Last updated in NPPESNovember 28, 2023
Certification dateNovember 28, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Grady Memorial Hospital Corporation — 363 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Union