Provider Demographics
NPI:1750896437
Name:ESSIEN, OLUSOLA AINA (CRNP)
Entity type:Individual
Prefix:
First Name:OLUSOLA
Middle Name:AINA
Last Name:ESSIEN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3214 BIRCHMEDE DR
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-2302
Mailing Address - Country:US
Mailing Address - Phone:443-687-2372
Mailing Address - Fax:
Practice Address - Street 1:3214 BIRCHMEDE DR
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-2302
Practice Address - Country:US
Practice Address - Phone:443-687-2372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-04
Last Update Date:2017-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR185014363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily