Provider Demographics
NPI:1780332106
Name:ADELEYE, JOHN ADELAJA (CRNP-PMH)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:ADELAJA
Last Name:ADELEYE
Suffix:
Gender:M
Credentials:CRNP-PMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6801 KENILWORTH AVE STE 300S2
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20737-1331
Mailing Address - Country:US
Mailing Address - Phone:301-512-9448
Mailing Address - Fax:
Practice Address - Street 1:6801 KENILWORTH AVE STE 300S2
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:MD
Practice Address - Zip Code:20737-1331
Practice Address - Country:US
Practice Address - Phone:301-512-9448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-15
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR140143363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health