Provider Demographics
NPI:1598381048
Name:OLANIYI, TEMITAYO BOSEDE (DNP,PMHNP-BC, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:TEMITAYO
Middle Name:BOSEDE
Last Name:OLANIYI
Suffix:
Gender:F
Credentials:DNP,PMHNP-BC, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1118 WALNUT HILL CT
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:MD
Mailing Address - Zip Code:21009-4309
Mailing Address - Country:US
Mailing Address - Phone:443-876-1283
Mailing Address - Fax:
Practice Address - Street 1:2203 PHILADELPHIA RD
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:MD
Practice Address - Zip Code:21040-1109
Practice Address - Country:US
Practice Address - Phone:410-612-0275
Practice Address - Fax:410-612-0287
Is Sole Proprietor?:No
Enumeration Date:2020-06-21
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR218156363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily