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NPI Code Detail

MEDICARE: OLUFUNMILAYO TITILOLA SOGBESAN PMHNP

MEDICARE: OLUFUNMILAYO TITILOLA SOGBESAN 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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerR226403MD

General Provider Information

NPI Number : 1750279618
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLUFUNMILAYO TITILOLA SOGBESAN PMHNP
Provider Business Mailing Address
First Line : 4301 GARDEN CITY DR STE 303
Second Line :
City : LANDOVER
State : MD
Zip : 20785-6105
Country : US
Telephone Number : 240-821-0298
Fax Number :
Provider Business Practice Location Address
First Line : 4301 GARDEN CITY DR STE 303
Second Line :
City : LANDOVER
State : MD
Zip : 20785-6105
Country : US
Telephone Number : 240-821-0298
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2025
Last Update Date : 06/15/2026

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