Provider Demographics
NPI:1194221788
Name:AJAYI, VICTORIA OLUFUNMILAYO (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:OLUFUNMILAYO
Last Name:AJAYI
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 EGYPT FARMS RD
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5043
Mailing Address - Country:US
Mailing Address - Phone:443-538-1383
Mailing Address - Fax:
Practice Address - Street 1:8713 HARFORD RD
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-4650
Practice Address - Country:US
Practice Address - Phone:443-636-6002
Practice Address - Fax:443-636-6002
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-02
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR125591363L00000X, 363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health