Provider Demographics
NPI:1548737299
Name:AKINYEMI, ADEKEMI ORIMISAN
Entity Type:Individual
Prefix:MRS
First Name:ADEKEMI
Middle Name:ORIMISAN
Last Name:AKINYEMI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 STRETHAM CT
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-4739
Mailing Address - Country:US
Mailing Address - Phone:443-872-9938
Mailing Address - Fax:
Practice Address - Street 1:6401 YORK RD STE 3
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212-2130
Practice Address - Country:US
Practice Address - Phone:410-877-3422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-31
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR196600363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
F10181180OtherAMERICAN ASSOCIATION OF NURSE PRACTITIONERS (AANP)
MDR196600OtherMARYLAND BOARD OF NURSING