Healthcare Provider Details

I. General information

NPI: 1467818807
Provider Name (Legal Business Name): RUKAYAT OLUWADAMILOLA BOJUWON NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2016
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 MASSACHUSSETTS AVENUE NE UNIT 1706
WASHINGTON DC
20013
US

IV. Provider business mailing address

2 MASSACHUSSETTS AVENUE NE UNIT 1706
WASHINGTON DC
20013
US

V. Phone/Fax

Practice location:
  • Phone: 202-408-7609
  • Fax:
Mailing address:
  • Phone: 202-408-7609
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberNP1052767
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberNP1052767
License Number StateDC
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP1052767
License Number StateDC
# 4
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberR237771
License Number StateMD
# 5
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1052767
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: