Provider Demographics
NPI:1588895411
Name:IBITOYE, OLAYINKA ABIMBOLA (NP)
Entity type:Individual
Prefix:
First Name:OLAYINKA
Middle Name:ABIMBOLA
Last Name:IBITOYE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:14011 WESTVIEW FOREST DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-4867
Mailing Address - Country:US
Mailing Address - Phone:301-352-4014
Mailing Address - Fax:240-245-4409
Practice Address - Street 1:12200 ANNAPOLIS RD
Practice Address - Street 2:SUITE 232
Practice Address - City:GLENN DALE
Practice Address - State:MD
Practice Address - Zip Code:20769-9182
Practice Address - Country:US
Practice Address - Phone:240-245-4414
Practice Address - Fax:240-245-4409
Is Sole Proprietor?:No
Enumeration Date:2009-07-27
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR145692363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health