Healthcare Provider Details

I. General information

NPI: 1043148711
Provider Name (Legal Business Name): JENNIFER OLAJIDE APRN, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MIDDLETOWN PKWY UNIT 202
MIDDLETOWN MD
21769-7767
US

IV. Provider business mailing address

100 MIDDLETOWN PKWY UNIT 202 PMB 5
MIDDLETOWN MD
21769-7767
US

V. Phone/Fax

Practice location:
  • Phone: 443-585-2565
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR202635
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: