Provider Demographics
NPI:1982172664
Name:OYENUGA, AYOOLA JULIANA (NP)
Entity Type:Individual
Prefix:DR
First Name:AYOOLA
Middle Name:JULIANA
Last Name:OYENUGA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2014 WHISTLING DUCK DR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-7139
Mailing Address - Country:US
Mailing Address - Phone:240-821-2195
Mailing Address - Fax:
Practice Address - Street 1:2014 WHISTLING DUCK DR
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-7139
Practice Address - Country:US
Practice Address - Phone:240-821-2195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-11
Last Update Date:2018-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD189802363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health