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General NPI Number Information
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NPI Number | 1790171296
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Entity Type | Individual
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Provider Name | OLUWATOYIN MARY OTTUN DNP, FNP-C, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 04/10/2015
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 810 BESTGATE RD STE 325
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City | ANNAPOLIS
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State | MD
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Zip | 21401-4291
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Country | US
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Telephone | 443-906-3506
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Fax |
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Provider Business Mailing Address
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Address Line | 2528 MOUNTAIN RD STE 204
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City | PASADENA
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State | MD
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Zip | 21122-7204
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Country | US
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Telephone | 443-548-3733
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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 | R188050
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R188050
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License Number State | MD
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