MEDICARE: SUNDAY ADEYEMI ADETOYESE CRNP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	R233731	MD

General Provider Information

NPI Number	:	1366306706
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUNDAY ADEYEMI ADETOYESE CRNP

Provider Business Mailing Address
First Line	:	10 CAMANO CT
Second Line	:
City	:	RANDALLSTOWN
State	:	MD
Zip	:	21133-2008
Country	:	US
Telephone Number	:	443-985-6893
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 CAMANO CT
Second Line	:
City	:	RANDALLSTOWN
State	:	MD
Zip	:	21133-2008
Country	:	US
Telephone Number	:	443-985-6893
Fax Number	:

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

Provider Enumeration Date	:	12/10/2025
Last Update Date	:	12/10/2025

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