Organization
PROLORD HEALTHCARE AND NURSING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLUSEYI SOFOLUWE CRNP (OWNER)
(301) 675-3270
Entity
Organization
Contact information
Practice address
13110 3RD ST, BOWIE, MD 20720-3745
(301) 675-3270
(240) 202-3783
Mailing address
13110 3RD ST, BOWIE, MD 20720-3745
(301) 675-3270
(240) 202-3783
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
143240100
—
MD
Enumeration date
02/11/2021
Last updated
02/11/2021
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