Organization
FAWPEARLS HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABIMBOLA SHADARE NP (NURSE PRACTITIONER)
(240) 593-2260
Entity
Organization
Contact information
Practice address
8301 PROFESSIONAL PL, HYATTSVILLE, MD 20785-2237
(301) 532-5849
Mailing address
4312 ARABELLA CT, UPPER MARLBORO, MD 20772-9343
(240) 593-2260
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
07/07/2025
Last updated
03/31/2026
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