Healthcare Provider Details

I. General information

NPI: 1699186676
Provider Name (Legal Business Name): FOLASADE ADEWUNMI AGPCNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2014
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7520 SURRATTS RD
CLINTON MD
20735-3353
US

IV. Provider business mailing address

2509 SAINT NICHOLAS WAY
GLENARDEN MD
20706-1679
US

V. Phone/Fax

Practice location:
  • Phone: 301-856-1660
  • Fax:
Mailing address:
  • Phone: 301-437-6351
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR182253
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberR182253
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: