Provider Demographics
NPI:1073286431
Name:USUAH, ADEBOLA RITA (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:ADEBOLA
Middle Name:RITA
Last Name:USUAH
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MRS
Other - First Name:ADEBOLA
Other - Middle Name:RITA
Other - Last Name:USUAH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN
Mailing Address - Street 1:172 HAUT BRION AVE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-4542
Mailing Address - Country:US
Mailing Address - Phone:302-339-2260
Mailing Address - Fax:
Practice Address - Street 1:1601 MILLTOWN RD STE 2
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-4047
Practice Address - Country:US
Practice Address - Phone:302-543-6165
Practice Address - Fax:302-525-4432
Is Sole Proprietor?:No
Enumeration Date:2021-07-30
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0011686363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner