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General NPI Number Information
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NPI Number | 1689430936
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Entity Type | Individual
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Provider Name | ADEOLA RITA OMORUYI CRNP
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Gender | Female
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Dates
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Enumeration Date | 02/26/2024
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 901 HARRY S TRUMAN DR N
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City | LARGO
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State | MD
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Zip | 20774-5477
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Country | US
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Telephone | 240-677-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 11305 OLD PROSPECT HILL RD
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City | GLENN DALE
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State | MD
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Zip | 20769-9423
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Country | US
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Telephone | 240-354-9483
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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 | R231913
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN200006296
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R231913
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License Number State | MD
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