Individual provider · Type 1 NPI
Bose Ajayi
Psychiatric/Mental Health Nurse Practitioner · Fairfax, VA
NPI number
1043882533
Active
Practice location
11166 Fairfax Blvd Ste 308
Fairfax, VA 22030-5017
Mailing address
8280 Willow Oaks Corporate Dr Ste 600
Fairfax, VA 22031-4516
Other practice locations
- 800 Maine Ave SW, Washington, DC 20024-2805 · (202) 730-5436
- 8280 Willow Oaks Corporate Dr Ste 600, Fairfax, VA 22031-4516 · (202) 730-5436
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | NONE (DC) |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | NP1024705 (DC) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 0024182918 (VA) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1043882533
Bose Ajayi's National Provider Identifier is 1043882533, issued on Jul 14, 2021. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Fairfax, VA. The record was last updated on Oct 29, 2026.