OLUWAKEMI OLUBUNMI OSIDELE (NPI# 1649649468) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649649468 |
| Entity Type | Individual |
| Full Name | OLUWAKEMI OLUBUNMI OSIDELE |
| Credential | DNP, FNP-C, CRNP |
| Practice Address |
188 Thomas Johnson Dr Ste 102 Frederick MD 21702 |
| Mailing Address |
15643 Whispering Knoll Ct. Purceville VA 20743-5767 |
| Practice Telephone | 2405759940 |
| Practice Fax Number | 2405759481 |
| Mailing Telephone | 2402773768 |
| Enumeration Date | 2015-09-22 |
| Last Update Date | 2018-08-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | RN1020313 | DC | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363L00000X | Nurse Practitioner | R191391 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R191391 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
0024172973 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 1649649468 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 15643 Whispering Knoll Ct, Purcellville, VA 201322570 | 2402773768 | 2402773768 |
| 5474 Saint Barnabas Rd, Oxon Hill, MD 207453622 | 2402773768 |
| Street Address |
188 THOMAS JOHNSON DR STE 102 |
| City | FREDERICK |
| State | MD |
| Zip Code | 21702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073129714 | Rita Akowuah | Nurse Practitioner | 1302 Baker Place East Apt 14, Frederick, MD 21702 | 2020-09-18 |
| 1912416272 | Morgan Nicely | Behavior Technician | 65 Thomas Johnson Drive Suite A, Frederick, MD 21702 | 2017-09-29 |
| 1154840494 | Centers for Advanced Orthopaedics, LLC | Orthopaedic Surgery | 184 Thomas Johnson Dr Ste 104, Frederick, MD 21702 | 2017-09-19 |
| 1831617471 | Hazel Elizabeth Gill | Physical Therapy Assistant | 2007 Butterfield Overlook, Frederick, MD 21702 | 2017-09-05 |
| 1831610161 | William Haynes | Nurse Practitioner | 103 Water Land Ct., Frederick, MD 21702 | 2017-06-27 |
| 1497299333 | Timothy Stimach | Pharmacist | 1430b W Patrick St, Frederick, MD 21702 | 2016-12-12 |
| 1184167405 | Maryland Nutrition and Diet Services, L.L.C. | Dietitian, Registered | 1301 W. 7th Street, No. 1607, Frederick, MD 21702 | 2016-11-18 |
| 1841678562 | Ventzislava Hristova | Spec/Tech, Pathology | 1050 Boyles St. Building 560 Room 12-39, National Cancer Institute - Frederick, Frederick, MD 21702 | 2015-05-14 |
| 1023404571 | Mychal Lynn Pilia | Advanced Practice Midwife | 7420 Hayward Road, Suite 104, Frederick, MD 21702 | 2015-04-11 |
| 1821483223 | Brian Tuminski | Podiatrist | 141 Thomas Johnson Dr Ste 170, Frederick, MD 21702 | 2015-04-02 |
| Find all providers in zip 21702 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073129714 | Rita Akowuah | Nurse Practitioner | 1302 Baker Place East Apt 14, Frederick, MD 21702 | 2020-09-18 |
| 1356957252 | True Vitality Consulting Dba Peridot Health | Nurse Practitioner | 5255 Buckeystown Pike, Frederick, MD 21704-7535 | 2020-09-17 |
| 1285288282 | Augusto Paredes Ubillus | Nurse Practitioner | 110 Baughmans Ln Ste 140, Frederick, MD 21702-4649 | 2019-07-29 |
| 1912561408 | Christine Noyan-lue | Nurse Practitioner | 9516 Bridgewater Ct E, Frederick, MD 21701-7619 | 2019-04-30 |
| 1720642986 | Ashley Marie Fox | Nurse Practitioner | 1305 W 7th St Ste 28, Frederick, MD 21702-4100 | 2019-04-23 |
| 1265997845 | Karen Gregory | Nurse Practitioner | 9330 Bishopgate Dr, Frederick, MD 21704-7356 | 2019-02-07 |
| 1447735352 | Ezcare Clinic LLC | Nurse Practitioner | 1519 W Patrick St Ste A1, Frederick, MD 21702-3763 | 2018-09-26 |
| 1801378435 | Saving Lives Center LLC | Nurse Practitioner | 3 Hillcrest Dr Ste A101, Frederick, MD 21703-6105 | 2018-08-30 |
| 1235655903 | Laura Jane Kannaian | Nurse Practitioner | 176 Thomas Johnson Dr Ste 104, Frederick, MD 21702-4499 | 2017-08-15 |
| 1265961312 | Rebecca M Barker | Nurse Practitioner | 182 Thomas Johnson Dr Ste 100, Frederick, MD 21702-4486 | 2017-06-11 |
| Find all providers in FREDERICK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.