Provider Demographics
NPI:1932644267
Name:ABOYEWA, MORONKE OLUFUNMIBI (CRNP-PMH)
Entity Type:Individual
Prefix:MRS
First Name:MORONKE
Middle Name:OLUFUNMIBI
Last Name:ABOYEWA
Suffix:
Gender:F
Credentials:CRNP-PMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3611 CARA DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20774-5438
Mailing Address - Country:US
Mailing Address - Phone:240-462-5485
Mailing Address - Fax:
Practice Address - Street 1:3611 CARA DR
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:MD
Practice Address - Zip Code:20774-5438
Practice Address - Country:US
Practice Address - Phone:240-462-5485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-22
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR197333363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health