Provider Demographics
NPI:1518368018
Name:OGUNDIPE, ADEBOLA (RN)
Entity Type:Individual
Prefix:MRS
First Name:ADEBOLA
Middle Name:
Last Name:OGUNDIPE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11315 KENCREST DR.
Mailing Address - Street 2:
Mailing Address - City:MITCHELLVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20721
Mailing Address - Country:US
Mailing Address - Phone:202-955-8355
Mailing Address - Fax:
Practice Address - Street 1:1010 WISCONSIN AVE NW.
Practice Address - Street 2:SUITE 300
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007
Practice Address - Country:US
Practice Address - Phone:202-955-8355
Practice Address - Fax:202-289-5461
Is Sole Proprietor?:No
Enumeration Date:2014-09-16
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN56557163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse