Healthcare Provider Details

I. General information

NPI: 1831622216
Provider Name (Legal Business Name): ADEDAYO AKINLOFA CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2017
Last Update Date: 11/04/2023
Certification Date: 11/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4367 HOLLINS FERRY RD
BALTIMORE MD
21227-3400
US

IV. Provider business mailing address

528 DUSK VIEW DR
HAVRE DE GRACE MD
21078-2368
US

V. Phone/Fax

Practice location:
  • Phone: 443-415-8427
  • Fax:
Mailing address:
  • Phone: 443-415-8427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR177004
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR177004
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: