MEDICARE: MS. ADENIKE JANET FALADE PMHNP

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	R230618	MD

General Provider Information

NPI Number	:	1508645722
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ADENIKE JANET FALADE PMHNP

Provider Business Mailing Address
First Line	:	13708 IVYWOOD LN
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-5466
Country	:	US
Telephone Number	:	301-602-2574
Fax Number	:

Provider Business Practice Location Address
First Line	:	8484 GEORGIA AVE STE 900
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-5604
Country	:	US
Telephone Number	:	301-706-1724
Fax Number	:

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

Provider Enumeration Date	:	09/26/2023
Last Update Date	:	09/26/2023

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