Provider Demographics
NPI:1477188316
Name:OFI-OLUKULOYE, MOTUNRAYO FOLUKEMI (CRNP)
Entity Type:Individual
Prefix:
First Name:MOTUNRAYO
Middle Name:FOLUKEMI
Last Name:OFI-OLUKULOYE
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 1:1001 YORK RD
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2516
Mailing Address - Country:US
Mailing Address - Phone:410-823-3900
Mailing Address - Fax:
Practice Address - Street 1:1001 YORK RD
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2516
Practice Address - Country:US
Practice Address - Phone:410-823-3900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-11
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR210787363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner