Provider Demographics
NPI:1548061591
Name:AKINSEYE, ALEX BABATUNDE (PMHNP)
Entity type:Individual
Prefix:
First Name:ALEX
Middle Name:BABATUNDE
Last Name:AKINSEYE
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5726 CRESTRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21703-1854
Mailing Address - Country:US
Mailing Address - Phone:240-477-0077
Mailing Address - Fax:
Practice Address - Street 1:5726 CRESTRIDGE CT
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21703-1854
Practice Address - Country:US
Practice Address - Phone:240-477-0077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR221506363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health