Provider Demographics
NPI:1215417415
Name:AKEREDOLU, EMILOLA ELIZABETH (FNP)
Entity Type:Individual
Prefix:
First Name:EMILOLA
Middle Name:ELIZABETH
Last Name:AKEREDOLU
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:EMILOLA
Other - Middle Name:LOLA
Other - Last Name:AKINSEYE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7474 GREENWAY CENTER DR
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-3504
Mailing Address - Country:US
Mailing Address - Phone:301-441-3050
Mailing Address - Fax:301-441-1148
Practice Address - Street 1:7474 GREENWAY CENTER DR
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770
Practice Address - Country:US
Practice Address - Phone:301-441-3050
Practice Address - Fax:301-441-1148
Is Sole Proprietor?:No
Enumeration Date:2018-08-16
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR211332363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily