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General NPI Number Information
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NPI Number | 1972077295
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Entity Type | Individual
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Provider Name | RASHIDAT ODEYALE NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 01/21/2019
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Last Update Date | 12/04/2024
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Provider Practice Location Address
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Address Line | 388 GAMBRILLS RD UNIT 618
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City | GAMBRILLS
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State | MD
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Zip | 21054-7524
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Country | US
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Telephone | 240-927-0957
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Fax |
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Provider Business Mailing Address
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Address Line | 388 GAMBRILLS RD UNIT 618
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City | GAMBRILLS
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State | MD
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Zip | 21054-7524
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Country | US
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Telephone | 240-927-0957
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R269551
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License Number State | MD
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