Provider Demographics
NPI:1942986641
Name:OLANIYI, VICTORIA A
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:A
Last Name:OLANIYI
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 1:17106 BIRCH LEAF TER
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-3637
Mailing Address - Country:US
Mailing Address - Phone:301-219-5202
Mailing Address - Fax:
Practice Address - Street 1:17106 BIRCH LEAF TER
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-3637
Practice Address - Country:US
Practice Address - Phone:301-219-5202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR180887363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health