Healthcare Provider Details

I. General information

NPI: 1609787423
Provider Name (Legal Business Name): ENIOLA JOY OSUNNUGA WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2224 SOUTHLAND RD
GWYNN OAK MD
21207-6037
US

IV. Provider business mailing address

2224 SOUTHLAND RD
GWYNN OAK MD
21207-6037
US

V. Phone/Fax

Practice location:
  • Phone: 443-813-4958
  • Fax:
Mailing address:
  • Phone: 443-813-4958
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberR254270
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: