Healthcare Provider Details

I. General information

NPI: 1538090733
Provider Name (Legal Business Name): OLUWATOSIN TOLULOPE OLUOKUN DCN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12002 SHADYSTONE TER
BOWIE MD
20721-2593
US

IV. Provider business mailing address

12002 SHADYSTONE TER
BOWIE MD
20721-2593
US

V. Phone/Fax

Practice location:
  • Phone: 240-565-7262
  • Fax: 240-565-7262
Mailing address:
  • Phone: 240-565-7262
  • Fax: 240-565-7262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: