Individual provider · Type 1 NPI

Modinat Oluwatoyin Fagbenro, PMHNP-BC

Psychiatric/Mental Health Nurse Practitioner · Lutherville Timonium, MD

NPI number 1063061034 Active

Practice location

22 W Padonia Rd Ste C252
Lutherville Timonium, MD 21093-2241

Call (410) 768-6088 Map

Fax (410) 768-6444

Mailing address

4105 Daylily Dr
Owings Mills, MD 21117-5034

Other practice locations

  • 4105 Daylily Dr, Owings Mills, MD 21117-5034 · (410) 800-4471

Specialties and licenses

TaxonomyCodeLicense
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808XR210603 (MD)

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

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About NPI 1063061034

Modinat Oluwatoyin Fagbenro, PMHNP-BC's National Provider Identifier is 1063061034, issued on Sep 11, 2019. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Lutherville Timonium, MD. The record was last updated on Jan 20, 2026.