Individual
DR. OLUKOREDE GISANRIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9600 MARILYN IVY CT, UPPER MARLBORO, MD 20772-4509
(240) 533-8778
Mailing address
9600 MARILYN IVY CT, UPPER MARLBORO, MD 20772-4509
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R192641
MD
363LF0000X
Family Nurse Practitioner
Primary
R192641
MD
Other
Enumeration date
08/28/2024
Last updated
09/10/2024
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