Provider Demographics
NPI:1407535263
Name:ASHADE, OLUWAKEMI OYEYEMI
Entity Type:Individual
Prefix:
First Name:OLUWAKEMI
Middle Name:OYEYEMI
Last Name:ASHADE
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 1:5272 MARLBORO PIKE
Mailing Address - Street 2:
Mailing Address - City:CAPITOL HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20743-5436
Mailing Address - Country:US
Mailing Address - Phone:240-392-5466
Mailing Address - Fax:
Practice Address - Street 1:5272 MARLBORO PIKE
Practice Address - Street 2:
Practice Address - City:CAPITOL HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20743-5436
Practice Address - Country:US
Practice Address - Phone:240-392-5466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD376K00000X
MDA0019728376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide