Healthcare Provider Details

I. General information

NPI: 1508645722
Provider Name (Legal Business Name): ADENIKE JANET FALADE PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ADENIKE JANET FALADE PMHNP

II. Dates (important events)

Enumeration Date: 09/26/2023
Last Update Date: 09/26/2023
Certification Date: 09/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8484 GEORGIA AVE STE 900
SILVER SPRING MD
20910-5604
US

IV. Provider business mailing address

13708 IVYWOOD LN
SILVER SPRING MD
20904-5466
US

V. Phone/Fax

Practice location:
  • Phone: 301-706-1724
  • Fax:
Mailing address:
  • Phone: 301-602-2574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR230618
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: