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General NPI Number Information
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NPI Number | 1174226682
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Entity Type | Individual
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Provider Name | SAIDAT ABOSEDE OLUWATUYI NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 03/23/2023
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Last Update Date | 07/10/2024
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Provider Practice Location Address
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Address Line | 702 15TH ST NE
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City | WASHINGTON
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State | DC
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Zip | 20002-4508
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Country | US
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Telephone | 301-272-0788
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Fax | 202-847-3209
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Provider Business Mailing Address
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Address Line | 702 15TH ST NE
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City | WASHINGTON
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State | DC
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Zip | 20002-4508
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Country | US
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Telephone | 240-696-9923
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | NP1050197
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | NP1050197
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License Number State | DC
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