Provider Demographics
NPI:1902371321
Name:AKINSOLA, TITILAYO (CRNP, PMHNP)
Entity Type:Individual
Prefix:
First Name:TITILAYO
Middle Name:
Last Name:AKINSOLA
Suffix:
Gender:F
Credentials:CRNP, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2945 EMMORTON RD UNIT 444
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:MD
Mailing Address - Zip Code:21009-7518
Mailing Address - Country:US
Mailing Address - Phone:301-793-8791
Mailing Address - Fax:
Practice Address - Street 1:8136 LIBERTY RD STE C
Practice Address - Street 2:
Practice Address - City:WINDSOR MILL
Practice Address - State:MD
Practice Address - Zip Code:21244-3021
Practice Address - Country:US
Practice Address - Phone:301-793-8791
Practice Address - Fax:410-862-4350
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-11
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR168386363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR168386OtherCRNP