Healthcare Provider Details

I. General information

NPI: 1437524899
Provider Name (Legal Business Name): OLAYEMI ABIOLA ADUROTA DNP, PMHNP-BC, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2015
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13400 EDGEMEADE RD
UPPER MARLBORO MD
20772-8088
US

IV. Provider business mailing address

4001 PENDENNIS CT
UPPER MARLBORO MD
20772-8304
US

V. Phone/Fax

Practice location:
  • Phone: 240-825-9529
  • Fax:
Mailing address:
  • Phone: 240-825-9529
  • Fax: 240-753-7279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR201105
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR201105
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: