Provider Demographics
NPI:1053167270
Name:ADELAKUN, OLUWATOYIN RACHAEL
Entity type:Individual
Prefix:
First Name:OLUWATOYIN
Middle Name:RACHAEL
Last Name:ADELAKUN
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 1:10612 CHERYL TURN
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20603-6914
Mailing Address - Country:US
Mailing Address - Phone:301-377-4325
Mailing Address - Fax:
Practice Address - Street 1:10612 CHERYL TURN
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20603-6914
Practice Address - Country:US
Practice Address - Phone:301-377-4325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR232283363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health