Healthcare Provider Details

I. General information

NPI: 1528647757
Provider Name (Legal Business Name): ADEBUKOLA ABIOLA ADEBAYO DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2021
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1234 WASHINGTON RD
WESTMINSTER MD
21157-5854
US

IV. Provider business mailing address

56 W MAIN ST
WESTMINSTER MD
21157-4844
US

V. Phone/Fax

Practice location:
  • Phone: 410-848-0700
  • Fax:
Mailing address:
  • Phone: 410-753-4435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR217955
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: