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General NPI Number Information
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NPI Number | 1801312053
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Entity Type | Individual
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Provider Name | ADEDIWURA AJADI JOLAOSO AGNP, PMHNP
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Gender | Female
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Dates
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Enumeration Date | 08/18/2017
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 807 E BALTIMORE ST UNIT 1-R
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City | BALTIMORE
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State | MD
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Zip | 21202-4706
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Country | US
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Telephone | 240-245-4164
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Fax |
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Provider Business Mailing Address
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Address Line | 3904 DEEP HOLLOW WAY
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City | BOWIE
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State | MD
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Zip | 20721-1287
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Country | US
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Telephone | 240-245-4164
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | NP1028737
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | R193343
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | R193343
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | NP1028737
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License Number State | DC
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Taxonomy #5
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R193343
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License Number State | MD
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