MEDICARE: TRUVIT PRIMARY CARE

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	363LP2300X	Primary Care Nurse Practitioner

General Provider Information

NPI Number	:	1164363313
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRUVIT PRIMARY CARE

Provider Business Mailing Address
First Line	:	10296 BALTIMORE NATIONAL PIKE STE A
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21042-3670
Country	:	US
Telephone Number	:	240-732-1009
Fax Number	:	240-755-0102

Provider Business Practice Location Address
First Line	:	10296 BALTIMORE NATIONAL PIKE STE A
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21042-3670
Country	:	US
Telephone Number	:	240-732-1009
Fax Number	:	240-755-0102

Authorized Official
Title or Position	:	CEO
Name	:	OLANIRETI ONABANJO
Credential	:	DNP
Telephone Number	:	240-732-1009

Provider Enumeration Date	:	04/02/2026
Last Update Date	:	04/02/2026

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Directions to “TRUVIT PRIMARY CARE ” Practice Location

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