Provider Demographics
NPI:1508644253
Name:OLUWO, AINA (PMHNP -BC)
Entity Type:Individual
Prefix:MRS
First Name:AINA
Middle Name:
Last Name:OLUWO
Suffix:
Gender:F
Credentials:PMHNP -BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9600 BYWARD BLVD
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-1893
Mailing Address - Country:US
Mailing Address - Phone:301-526-2276
Mailing Address - Fax:
Practice Address - Street 1:9600 BYWARD BLVD
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-1893
Practice Address - Country:US
Practice Address - Phone:301-526-2276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-14
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR229546363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health