Healthcare Provider Details

I. General information

NPI: 1346875804
Provider Name (Legal Business Name): MARGARET OLOYEDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2020
Last Update Date: 03/05/2020
Certification Date: 03/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 LINCOLN ST
NORWOOD MA
02062-1347
US

IV. Provider business mailing address

123 LINCOLN ST
NORWOOD MA
02062-1347
US

V. Phone/Fax

Practice location:
  • Phone: 781-492-5248
  • Fax:
Mailing address:
  • Phone: 781-492-5248
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2277881
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: