MEDICARE: NIHINLOLA DEBORAH OLAIGBE FNP-BC

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
1	363LF0000X	Family Nurse Practitioner	R209069	MD

General Provider Information

NPI Number	:	1982316766
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NIHINLOLA DEBORAH OLAIGBE FNP-BC

Provider Business Mailing Address
First Line	:	14000 JERICHO PARK RD RM 2108
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20715-3319
Country	:	US
Telephone Number	:	301-860-3206
Fax Number	:

Provider Business Practice Location Address
First Line	:	14000 JERICHO PARK RD RM 2108
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20715-3319
Country	:	US
Telephone Number	:	301-860-3206
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/23/2022
Last Update Date	:	12/23/2022

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