Provider Demographics
NPI:1700639184
Name:OKELOLA, FOLASADE
Entity Type:Individual
Prefix:
First Name:FOLASADE
Middle Name:
Last Name:OKELOLA
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 1:7206 WILLOW HILL DR
Mailing Address - Street 2:
Mailing Address - City:CAPITOL HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20743-2671
Mailing Address - Country:US
Mailing Address - Phone:253-223-8890
Mailing Address - Fax:
Practice Address - Street 1:7206 WILLOW HILL DR
Practice Address - Street 2:
Practice Address - City:CAPITOL HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20743-2671
Practice Address - Country:US
Practice Address - Phone:253-223-8890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA200003719374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide