Healthcare Provider Details

I. General information

NPI: 1497279053
Provider Name (Legal Business Name): HARA OYEDEJI APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2017
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 PLEASANT RIDGE DR STE G
OWINGS MILLS MD
21117-2560
US

IV. Provider business mailing address

20 PLEASANT RIDGE DR STE G
OWINGS MILLS MD
21117-2560
US

V. Phone/Fax

Practice location:
  • Phone: 443-438-6893
  • Fax: 443-869-4437
Mailing address:
  • Phone: 443-438-6893
  • Fax: 443-869-4437

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR200287
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: