Provider Demographics
NPI:1992204937
Name:AKINYEMI, BABATUNDE OLUSEGUN (FNP-C/PMHNP-BC)
Entity Type:Individual
Prefix:DR
First Name:BABATUNDE
Middle Name:OLUSEGUN
Last Name:AKINYEMI
Suffix:
Gender:M
Credentials:FNP-C/PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6115 85TH PL
Mailing Address - Street 2:
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-2843
Mailing Address - Country:US
Mailing Address - Phone:202-288-7630
Mailing Address - Fax:
Practice Address - Street 1:100 S MARKET ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-5527
Practice Address - Country:US
Practice Address - Phone:202-288-7630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-05
Last Update Date:2021-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR200780363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily