Healthcare Provider Details

I. General information

NPI: 1497670582
Provider Name (Legal Business Name): ANUOLUWAPO OSILESI AGPCNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7105 SANDY SPRING RD
LAUREL MD
20707-5309
US

IV. Provider business mailing address

7105 SANDY SPRING RD
LAUREL MD
20707-5309
US

V. Phone/Fax

Practice location:
  • Phone: 240-604-2294
  • Fax:
Mailing address:
  • Phone: 240-604-2294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberR226710
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: