Provider Demographics
NPI:1811274632
Name:SIJUWADE, ADEJOKE (CRNP-FAMILY)
Entity type:Individual
Prefix:MS
First Name:ADEJOKE
Middle Name:
Last Name:SIJUWADE
Suffix:
Gender:F
Credentials:CRNP-FAMILY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5999 HARPERS FARM RD STE W230
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3025
Mailing Address - Country:US
Mailing Address - Phone:240-931-0658
Mailing Address - Fax:240-732-0240
Practice Address - Street 1:5999 HARPERS FARM RD STE W230
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3025
Practice Address - Country:US
Practice Address - Phone:240-931-0658
Practice Address - Fax:240-732-0240
Is Sole Proprietor?:No
Enumeration Date:2011-11-08
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR174161363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily