Healthcare Provider Details

I. General information

NPI: 1851956023
Provider Name (Legal Business Name): OLAPEJU ODU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2019
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

695 HANOVER PIKE UNIT H
HAMPSTEAD MD
21074-2015
US

IV. Provider business mailing address

695 HANOVER PIKE UNIT H
HAMPSTEAD MD
21074-2015
US

V. Phone/Fax

Practice location:
  • Phone: 301-404-9354
  • Fax:
Mailing address:
  • Phone: 301-404-9354
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LC1500X
TaxonomyCommunity Health Nurse Practitioner
License NumberR166121
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License NumberR166121
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberR166121
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberR166121
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: