Individual provider · Type 1 NPI
Bolaji Olugboja
Psychiatric/Mental Health Nurse Practitioner · Randallstown, MD
NPI number
1689005043
Active
Practice location
8515 Liberty Rd Ste B
Randallstown, MD 21133-4832
Fax (410) 496-3121
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction Medicine (Family Medicine) Physician | 207QA0401X | R178347 (MD) |
| Family Nurse Practitioner | 363LF0000X | R178347 (MD) |
| Primary Care Nurse Practitioner | 363LP2300X | R210237 (MD) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | R178347 (MD) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1689005043
Bolaji Olugboja's National Provider Identifier is 1689005043, issued on Dec 10, 2013. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Randallstown, MD. The record was last updated on Dec 22, 2021.