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Individual

MRS. FOLUKE TITILAYO OMOBO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP-PMH

Contact information

Practice address
17008 USHER PL, UPPER MARLBORO, MD 20772-3443
(240) 552-2390
Mailing address
17008 USHER PLACE, USHER PLACE, UPPER MARLBORO, MD 20772
(240) 552-2390

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R210277
MD
163W00000X
Registered Nurse
RN1033206
DC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R210277
MD

Other

Enumeration date
02/01/2017
Last updated
08/16/2022
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