Provider Demographics
NPI:1124459995
Name:OGUNKUNLE, FOLUKE
Entity type:Individual
Prefix:
First Name:FOLUKE
Middle Name:
Last Name:OGUNKUNLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2240 BRIGHTSEAT RD
Mailing Address - Street 2:APT 301
Mailing Address - City:LANDOVER
Mailing Address - State:MD
Mailing Address - Zip Code:20785-3525
Mailing Address - Country:US
Mailing Address - Phone:832-561-7840
Mailing Address - Fax:
Practice Address - Street 1:2240 BRIGHTSEAT RD
Practice Address - Street 2:APT 301
Practice Address - City:LANDOVER
Practice Address - State:MD
Practice Address - Zip Code:20785-3525
Practice Address - Country:US
Practice Address - Phone:832-561-7840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-04
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA5407374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide