Provider Demographics
NPI:1174800353
Name:DADA, OPEYEMI KEMIKI (PMHNP-BC, CPNP-PC)
Entity type:Individual
Prefix:
First Name:OPEYEMI
Middle Name:KEMIKI
Last Name:DADA
Suffix:
Gender:F
Credentials:PMHNP-BC, CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8401 MAYLAND DR # 7117
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23294-4648
Mailing Address - Country:US
Mailing Address - Phone:240-505-2416
Mailing Address - Fax:
Practice Address - Street 1:1308 SHERWOOD AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23220-1210
Practice Address - Country:US
Practice Address - Phone:804-828-3129
Practice Address - Fax:804-628-1236
Is Sole Proprietor?:No
Enumeration Date:2011-11-15
Last Update Date:2025-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELJ0000301363L00000X, 363LP0200X
MDR182034363LP0200X
DEL8-0010526363LP0808X
VA0024190248363LP0808X, 363LP0200X
IL209009246363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics