Provider Demographics
NPI:1285974451
Name:ILEKA-ADEOYE, NKECHI (MSN, CRNP, ANP-BC)
Entity type:Individual
Prefix:
First Name:NKECHI
Middle Name:
Last Name:ILEKA-ADEOYE
Suffix:
Gender:F
Credentials:MSN, CRNP, ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 THOMAS JOHNSON DR STE 201L
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-6200
Mailing Address - Country:US
Mailing Address - Phone:301-966-7610
Mailing Address - Fax:301-966-7611
Practice Address - Street 1:170 THOMAS JOHNSON DR STE 201L
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-6200
Practice Address - Country:US
Practice Address - Phone:301-966-7610
Practice Address - Fax:301-966-7611
Is Sole Proprietor?:No
Enumeration Date:2013-02-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR162273363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD824702100Medicaid