Provider Demographics
NPI:1710711635
Name:OLORUNOJE, AZEEZAT
Entity type:Individual
Prefix:
First Name:AZEEZAT
Middle Name:
Last Name:OLORUNOJE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2261 RUBY TURN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-1897
Mailing Address - Country:US
Mailing Address - Phone:615-779-2946
Mailing Address - Fax:
Practice Address - Street 1:2261 RUBY TURN
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-1897
Practice Address - Country:US
Practice Address - Phone:615-779-2946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-02
Last Update Date:2024-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA200004217374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide