Provider Demographics
NPI:1255128948
Name:ADEBIYI, OLAYINKA ADEOLA (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MS
First Name:OLAYINKA
Middle Name:ADEOLA
Last Name:ADEBIYI
Suffix:
Gender:
Credentials:NURSE PRACTITIONER
Other - Prefix:MS
Other - First Name:OLAYINKA
Other - Middle Name:ADEOLA
Other - Last Name:ADEBIYI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PMHNP-BC
Mailing Address - Street 1:7600 GOLDEN BEAR LN APT 204
Mailing Address - Street 2:
Mailing Address - City:MOSELEY
Mailing Address - State:VA
Mailing Address - Zip Code:23120-1892
Mailing Address - Country:US
Mailing Address - Phone:804-295-2404
Mailing Address - Fax:
Practice Address - Street 1:7600 GOLDEN BEAR LN
Practice Address - Street 2:
Practice Address - City:MOSELEY
Practice Address - State:VA
Practice Address - Zip Code:23120-1892
Practice Address - Country:US
Practice Address - Phone:804-295-2404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024193330363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty