Provider Demographics
NPI:1760641054
Name:AKINNAGBE, JUMOKE (BS)
Entity Type:Individual
Prefix:MISS
First Name:JUMOKE
Middle Name:
Last Name:AKINNAGBE
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6178
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-0178
Mailing Address - Country:US
Mailing Address - Phone:410-897-0514
Mailing Address - Fax:866-757-2727
Practice Address - Street 1:1997 ANNAPOLIS EXCHANGE PKWY
Practice Address - Street 2:SUITE 300
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3271
Practice Address - Country:US
Practice Address - Phone:410-897-0514
Practice Address - Fax:866-757-2727
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies