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General NPI Number Information
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NPI Number | 1316208770
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Entity Type | Individual
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Provider Name | ADEBOLA ADEWALE OLUDASI HHA
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Gender | Male
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Dates
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Enumeration Date | 06/01/2012
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 3217 75TH AVE APT 201
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City | LANDOVER
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State | MD
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Zip | 20785-1922
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Country | US
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Telephone | 301-257-4275
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Fax |
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Provider Business Mailing Address
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Address Line | 3151 ROLAND KENNER LOOP APT 303
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City | GLENARDEN
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State | MD
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Zip | 20706-2725
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Country | US
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Telephone | 301-257-4275
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | LPN1007593
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | LP50856
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | RN1059680
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License Number State | DC
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