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General NPI Number Information
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NPI Number | 1679086813
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Entity Type | Individual
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Provider Name | ABIOLA OLAKITAN OBATUASE NP
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Gender | Female
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Dates
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Enumeration Date | 11/09/2017
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 3350 WILKENS AVE STE 302
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City | BALTIMORE
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State | MD
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Zip | 21229-4618
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Country | US
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Telephone | 443-722-0954
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Fax |
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Provider Business Mailing Address
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Address Line | 15212 TORINO WAY
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City | WOODBINE
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State | MD
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Zip | 21797-9485
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Country | US
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Telephone | 410-800-4572
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Fax | 410-286-1923
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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 | R174133
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License Number State | MD
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