Provider Demographics
NPI:1629517230
Name:AKINYELE, OLUBUKOLA (NP-C)
Entity Type:Individual
Prefix:
First Name:OLUBUKOLA
Middle Name:
Last Name:AKINYELE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 E NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21213-1517
Mailing Address - Country:US
Mailing Address - Phone:410-675-2113
Mailing Address - Fax:410-675-2117
Practice Address - Street 1:2401 E NORTH AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21213-1517
Practice Address - Country:US
Practice Address - Phone:410-675-2113
Practice Address - Fax:410-675-2117
Is Sole Proprietor?:No
Enumeration Date:2017-02-15
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR170580363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily