Provider Demographics
NPI:1497279053
Name:OYEDEJI, HARA (APRN)
Entity Type:Individual
Prefix:
First Name:HARA
Middle Name:
Last Name:OYEDEJI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 E NORTHERN PKWY STE T6
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21239-2120
Mailing Address - Country:US
Mailing Address - Phone:443-438-6893
Mailing Address - Fax:443-869-4437
Practice Address - Street 1:1900 E NORTHERN PKWY STE T6
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21239-2120
Practice Address - Country:US
Practice Address - Phone:443-438-6893
Practice Address - Fax:443-869-4437
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-26
Last Update Date:2020-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR200287363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty