Provider Demographics
NPI:1043074974
Name:TOKAN, OLUBUNMI
Entity Type:Individual
Prefix:MRS
First Name:OLUBUNMI
Middle Name:
Last Name:TOKAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 BRIGHTSEAT RD # APYT2
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20785-3772
Mailing Address - Country:US
Mailing Address - Phone:240-615-0938
Mailing Address - Fax:
Practice Address - Street 1:1710 BRIGHTSEAT RD # APYT2
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20785-3772
Practice Address - Country:US
Practice Address - Phone:240-615-0938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA200003527374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide