Provider Demographics
NPI:1992506877
Name:AKOMOLAFE, OLUWATOYIN
Entity type:Individual
Prefix:
First Name:OLUWATOYIN
Middle Name:
Last Name:AKOMOLAFE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 KENDLE ST
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-1820
Mailing Address - Country:US
Mailing Address - Phone:240-467-1939
Mailing Address - Fax:
Practice Address - Street 1:204 KENDLE ST
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-1820
Practice Address - Country:US
Practice Address - Phone:240-467-1939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLPN200002940164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse