Healthcare Provider Details

I. General information

NPI: 1386275550
Provider Name (Legal Business Name): MONSURU OLUFEMI AKINYEMI PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/28/2020
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 BESTGATE RD STE 300
ANNAPOLIS MD
21401-7957
US

IV. Provider business mailing address

5457 TWIN KNOLLS RD STE 300
COLUMBIA MD
21045-3296
US

V. Phone/Fax

Practice location:
  • Phone: 410-364-4242
  • Fax: 410-352-6101
Mailing address:
  • Phone: 321-345-3694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR218529
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: