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General NPI Number Information
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NPI Number | 1417580168
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Entity Type | Individual
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Provider Name | TIWALOLA OLABISI AKINSADE FNP
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Gender | Female
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Dates
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Enumeration Date | 02/20/2020
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Last Update Date | 02/20/2020
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Provider Practice Location Address
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Address Line | 1496 REISTERSTOWN RD STE 220
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City | BALTIMORE
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State | MD
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Zip | 21208-3819
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Country | US
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Telephone | 301-497-1590
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Fax |
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Provider Business Mailing Address
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Address Line | 198 HALPINE RD APT 1426
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City | ROCKVILLE
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State | MD
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Zip | 20852-7628
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Country | US
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Telephone | 202-702-7242
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R172396
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License Number State | MD
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