Provider Demographics
NPI:1124713714
Name:AKINYEMI, OLUJUMOKE CHRISTIANAH (NP)
Entity type:Individual
Prefix:
First Name:OLUJUMOKE
Middle Name:CHRISTIANAH
Last Name:AKINYEMI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3149 W SPRINGS DR APT F
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-2952
Mailing Address - Country:US
Mailing Address - Phone:443-570-8047
Mailing Address - Fax:
Practice Address - Street 1:3149 W SPRINGS DR APT F
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-2952
Practice Address - Country:US
Practice Address - Phone:443-570-8047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR187370363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health