Provider Demographics
NPI:1619226537
Name:OSHIN, BAMGBOLA Y (RN)
Entity type:Individual
Prefix:
First Name:BAMGBOLA
Middle Name:Y
Last Name:OSHIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:BAMGBOLA
Other - Middle Name:Y
Other - Last Name:ABITOGUN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:357 SOFT RUSH LN
Mailing Address - Street 2:
Mailing Address - City:LA PLATA
Mailing Address - State:MD
Mailing Address - Zip Code:20646-9401
Mailing Address - Country:US
Mailing Address - Phone:240-726-9701
Mailing Address - Fax:
Practice Address - Street 1:8600 OLD GEORGETOWN RD
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-1497
Practice Address - Country:US
Practice Address - Phone:301-896-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-06
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1042574163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice