MEDICARE: AKEEM O SANNI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1134860018
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AKEEM O SANNI

Provider Business Mailing Address
First Line	:	3161 W SPRINGS DR APT B
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21043-2956
Country	:	US
Telephone Number	:	240-334-8462
Fax Number	:

Provider Business Practice Location Address
First Line	:	3161 W SPRINGS DR APT B
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21043-2956
Country	:	US
Telephone Number	:	240-334-8462
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/05/2022
Last Update Date	:	04/05/2022

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Directions to “ AKEEM O SANNI ” Practice Location

Language	Start Address	Practice Location

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