Healthcare Provider Details

I. General information

NPI: 1720581002
Provider Name (Legal Business Name): OLUWATOYIN OLAJIDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2018
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5718 HARFORD RD STE 202
BALTIMORE MD
21214-2243
US

IV. Provider business mailing address

1177 ANNAPOLIS RD UNIT 233
ODENTON MD
21113-7510
US

V. Phone/Fax

Practice location:
  • Phone: 443-218-8636
  • Fax: 443-200-0090
Mailing address:
  • Phone: 443-218-8636
  • Fax: 443-200-0900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR203066
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberR203066
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR203066
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: