Provider Demographics
NPI:1124314646
Name:OYEFUSI, OLUWAKEMI MARY (APRN, CRNP)
Entity type:Individual
Prefix:
First Name:OLUWAKEMI
Middle Name:MARY
Last Name:OYEFUSI
Suffix:
Gender:
Credentials:APRN, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 66315
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21239-6315
Mailing Address - Country:US
Mailing Address - Phone:410-302-7766
Mailing Address - Fax:888-858-1741
Practice Address - Street 1:516 N ROLLING RD STE 305
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4142
Practice Address - Country:US
Practice Address - Phone:410-302-7766
Practice Address - Fax:888-858-1741
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-22
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR185073363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily