Provider Demographics
NPI:1811183973
Name:ADEDEJI, DEBORAH GBEMISOLA (CRNP)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:GBEMISOLA
Last Name:ADEDEJI
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 1:1119 EAST-WEST HWY, SILVER SPRING, MD 20910
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING,
Mailing Address - State:MD
Mailing Address - Zip Code:20910-1206
Mailing Address - Country:US
Mailing Address - Phone:202-207-6878
Mailing Address - Fax:888-511-3073
Practice Address - Street 1:12817 FOX FERN LN
Practice Address - Street 2:
Practice Address - City:CLARKSBURG
Practice Address - State:MD
Practice Address - Zip Code:20871-4040
Practice Address - Country:US
Practice Address - Phone:240-755-1056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-21
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR202235363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health