Healthcare Provider Details

I. General information

NPI: 1568394161
Provider Name (Legal Business Name): MRS. OLUBUKOLA LOVE OLALEYE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2026
Last Update Date: 05/30/2026
Certification Date: 05/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9602 MAXWELL RD
MIDDLE RIVER MD
21220-3792
US

IV. Provider business mailing address

9602 MAXWELL RD
MIDDLE RIVER MD
21220-3792
US

V. Phone/Fax

Practice location:
  • Phone: 443-960-2182
  • Fax:
Mailing address:
  • Phone: 443-960-2182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR258759
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: