Healthcare Provider Details

I. General information

NPI: 1649803917
Provider Name (Legal Business Name): EBUNOLUWA AKINYEMI DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2020
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6211 BELAIR RD
BALTIMORE MD
21206-1942
US

IV. Provider business mailing address

3105 EMMORTON RD STE 2A
ABINGDON MD
21009-2587
US

V. Phone/Fax

Practice location:
  • Phone: 443-835-2942
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR206882
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: