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NPI Code Detail

MEDICARE: MODUPE ADEKUNLE

MEDICARE: MODUPE ADEKUNLE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner0024181084VA
2363LP0808XPsychiatric/Mental Health Nurse PractitionerNP1037670DC
3363LP0808XPsychiatric/Mental Health Nurse PractitionerR213801MD

General Provider Information

NPI Number : 1356926455
Entity Type Code : Individual
Provider Name (Legal Business Name) : MODUPE ADEKUNLE
Provider Business Mailing Address
First Line : 4000 BLACKBURN LN
Second Line :
City : BURTONSVILLE
State : MD
Zip : 20866-1104
Country : US
Telephone Number : 301-421-4241
Fax Number : 410-696-3696
Provider Business Practice Location Address
First Line : 4000 BLACKBURN LN STE 150
Second Line :
City : BURTONSVILLE
State : MD
Zip : 20866-6127
Country : US
Telephone Number : 301-421-4241
Fax Number : 410-696-3696
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2021
Last Update Date : 02/03/2026

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Directions to “ MODUPE ADEKUNLE ” Practice Location

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