Healthcare Provider Details

I. General information

NPI: 1811850092
Provider Name (Legal Business Name): ADENIKE KUDIRAT AWOSANYA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 KORADO CT APT 2
BALTIMORE MD
21244-3224
US

IV. Provider business mailing address

9 KORADO CT APT 2
BALTIMORE MD
21244-3224
US

V. Phone/Fax

Practice location:
  • Phone: 443-813-7183
  • Fax:
Mailing address:
  • Phone: 443-813-7183
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA200005365
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: