Provider Demographics
NPI:1326711409
Name:KAYODE, OLAWANLE L
Entity Type:Individual
Prefix:
First Name:OLAWANLE
Middle Name:L
Last Name:KAYODE
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 1:3413 RHODE ISLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT RAINIER
Mailing Address - State:MD
Mailing Address - Zip Code:20712-2067
Mailing Address - Country:US
Mailing Address - Phone:240-906-9138
Mailing Address - Fax:410-946-2010
Practice Address - Street 1:3413 RHODE ISLAND AVE
Practice Address - Street 2:
Practice Address - City:MOUNT RAINIER
Practice Address - State:MD
Practice Address - Zip Code:20712-2067
Practice Address - Country:US
Practice Address - Phone:240-906-9138
Practice Address - Fax:410-946-2010
Is Sole Proprietor?:No
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCNA0000812890376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide