Provider Demographics
NPI:1780225904
Name:AKINOLA, OLABISI A
Entity Type:Individual
Prefix:
First Name:OLABISI
Middle Name:A
Last Name:AKINOLA
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 1:5504 NEWTON ST
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20784-1157
Mailing Address - Country:US
Mailing Address - Phone:301-385-7283
Mailing Address - Fax:
Practice Address - Street 1:5504 NEWTON ST.
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20784-1157
Practice Address - Country:US
Practice Address - Phone:301-385-7283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-30
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide