MEDICARE: MRS. ABISOLA MORENIKE AKINWANDE RN

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	163W00000X	Registered Nurse	R221263	MD

General Provider Information

NPI Number	:	1730772575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ABISOLA MORENIKE AKINWANDE RN

Provider Business Mailing Address
First Line	:	8507 FALLS RUN RD APT C
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21043-7376
Country	:	US
Telephone Number	:	443-261-5906
Fax Number	:

Provider Business Practice Location Address
First Line	:	8507 FALLS RUN RD APT C
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21043-7376
Country	:	US
Telephone Number	:	443-261-5906
Fax Number	:

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

Provider Enumeration Date	:	02/12/2021
Last Update Date	:	02/12/2021

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