Organization
GOLDB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOBOLAJI O ROSANWO MSN, CRNP (OWNER OF ENTITY)
(443) 858-1968
Entity
Organization
Contact information
Practice address
4757 CLAIRELEE DR, OWINGS MILLS, MD 21117-4758
(443) 858-1968
Mailing address
4757 CLAIRELEE DR, OWINGS MILLS, MD 21117-4758
(443) 858-1968
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/21/2022
Last updated
09/21/2022
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