Provider Demographics
NPI:1023632882
Name:AJAO, TAIWO IKEOLUWA (MPH BSN RN)
Entity type:Individual
Prefix:MRS
First Name:TAIWO
Middle Name:IKEOLUWA
Last Name:AJAO
Suffix:
Gender:F
Credentials:MPH BSN RN
Other - Prefix:
Other - First Name:TAIWO
Other - Middle Name:TIA
Other - Last Name:ADELOYE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4209 DRESSAGE CT
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-5304
Mailing Address - Country:US
Mailing Address - Phone:410-913-0185
Mailing Address - Fax:
Practice Address - Street 1:4209 DRESSAGE CT
Practice Address - Street 2:
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133-5304
Practice Address - Country:US
Practice Address - Phone:410-913-0185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-07
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR214582163WH0200X, 163WM0102X, 163WP1700X
DCRN1050897163WP1700X
19117174H00000X
MD374J00000X
374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
No163WP1700XNursing Service ProvidersRegistered NursePerinatal
No174H00000XOther Service ProvidersHealth Educator