Provider Demographics
NPI:1932468568
Name:JUNAID, ABIMBOLA LATEEFAT (PMHNP)
Entity Type:Individual
Prefix:MS
First Name:ABIMBOLA
Middle Name:LATEEFAT
Last Name:JUNAID
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 JACQUE CT
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-7241
Mailing Address - Country:US
Mailing Address - Phone:301-237-7431
Mailing Address - Fax:
Practice Address - Street 1:507 JACQUE CT
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-7241
Practice Address - Country:US
Practice Address - Phone:301-237-7431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-16
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1044909163W00000X
MDR227202163W00000X
DCLPN1006138164W00000X
DCHHA0571374U00000X
MN2023207226363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse
No374U00000XNursing Service Related ProvidersHome Health Aide