Provider Demographics
NPI:1467818807
Name:BOJUWON, RUKAYAT OLUWADAMILOLA (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MISS
First Name:RUKAYAT
Middle Name:OLUWADAMILOLA
Last Name:BOJUWON
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 MASSACHUSSETTS AVENUE NE
Mailing Address - Street 2:UNIT 1706
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20013
Mailing Address - Country:US
Mailing Address - Phone:202-408-7609
Mailing Address - Fax:
Practice Address - Street 1:2 MASSACHUSSETTS AVENUE NE
Practice Address - Street 2:UNIT 1706
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20013
Practice Address - Country:US
Practice Address - Phone:202-408-7609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-14
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCNP1052767363LP2300X, 363LF0000X, 363LP0200X
MDR237771363LP2300X
DC1052767163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered Nurse
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics