Provider Demographics
NPI:1306673413
Name:ADEBAYO, ROFIAT ABAYOMI
Entity type:Individual
Prefix:MISS
First Name:ROFIAT
Middle Name:ABAYOMI
Last Name:ADEBAYO
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 1:251 NATIONAL HARBOR BLVD
Mailing Address - Street 2:
Mailing Address - City:NATIONAL HARBOR
Mailing Address - State:MD
Mailing Address - Zip Code:20745-1052
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:251 NATIONAL HARBOR BLVD
Practice Address - Street 2:
Practice Address - City:NATIONAL HARBOR
Practice Address - State:MD
Practice Address - Zip Code:20745-1052
Practice Address - Country:US
Practice Address - Phone:240-493-6110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-14
Last Update Date:2024-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR212845163WP2201X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care