Provider Demographics
NPI:1497573406
Name:ADEDO, BIMPE O (NP)
Entity type:Individual
Prefix:
First Name:BIMPE
Middle Name:O
Last Name:ADEDO
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 1:9717 BON HAVEN LN
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-7410
Mailing Address - Country:US
Mailing Address - Phone:443-929-5350
Mailing Address - Fax:
Practice Address - Street 1:9717 BON HAVEN LN
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-7410
Practice Address - Country:US
Practice Address - Phone:443-929-5350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR251812363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health