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NPI Code Detail

MEDICARE: OMOLARA OMOLABAKE AKINWANDE

MEDICARE: OMOLARA OMOLABAKE AKINWANDE
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
1163W00000XRegistered NurseRN965864DC

General Provider Information

NPI Number : 1952949133
Entity Type Code : Individual
Provider Name (Legal Business Name) : OMOLARA OMOLABAKE AKINWANDE
Provider Business Mailing Address
First Line : 11215 GEORGIA AVE APT 602
Second Line :
City : WHEATON
State : MD
Zip : 20902-4662
Country : US
Telephone Number : 240-701-3700
Fax Number :
Provider Business Practice Location Address
First Line : KBC NURSING AGENCY
Second Line : 7506 GEORGIA AVE NW WASHINGTON DC
City : WASHINGTON
State : DC
Zip : 20012-2001
Country : US
Telephone Number : 202-291-6976
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2019
Last Update Date : 12/18/2019

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Directions to “ OMOLARA OMOLABAKE AKINWANDE ” Practice Location

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