Healthcare Provider Details

I. General information

NPI: 1720597420
Provider Name (Legal Business Name): MARGARET TEMITAYO OWOLABI DNP, FNP-C, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2017
Last Update Date: 09/27/2023
Certification Date: 09/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5513 YORK RD
BALTIMORE MD
21212-3804
US

IV. Provider business mailing address

5513 YORK RD
BALTIMORE MD
21212-3804
US

V. Phone/Fax

Practice location:
  • Phone: 443-825-2955
  • Fax: 410-800-2506
Mailing address:
  • Phone: 443-825-2955
  • Fax: 410-800-2506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR208776
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR208776
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: