=====================================================
General NPI Number Information
=====================================================
NPI Number | 1396376075
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ABIOLA OSHIN CRNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/30/2020
-----------------------------------------------------
Last Update Date | 08/23/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3004 AILSA AVE STE E
-----------------------------------------------------
City | BALTIMORE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21214-2968
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-941-8212
-----------------------------------------------------
Fax | 410-941-8244
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 31 GREENLEAF RD
-----------------------------------------------------
City | PARKVILLE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21234-3369
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-615-3877
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | R208018
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------