Provider Demographics
NPI:1205656295
Name:OLALEYE, GRACE (RN)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:OLALEYE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4431 KENTFORD RD
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-4873
Mailing Address - Country:US
Mailing Address - Phone:443-983-0124
Mailing Address - Fax:
Practice Address - Street 1:4431 KENTFORD RD
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-4873
Practice Address - Country:US
Practice Address - Phone:443-983-0124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR150431163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse