Healthcare Provider Details

I. General information

NPI: 1851941199
Provider Name (Legal Business Name): TEMILOLA Y ESAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2019
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2015 GRAND CONCOURSE
BRONX NY
10453-4303
US

IV. Provider business mailing address

1829 BARRINGTON CT
BOWIE MD
20721-2701
US

V. Phone/Fax

Practice location:
  • Phone: 718-583-7736
  • Fax: 718-537-6180
Mailing address:
  • Phone: 301-326-0729
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF405519
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberNP1043774
License Number StateDC
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR225403
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: