Individual
BOLA T MOBOLAJI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
10201 GRAND CENTRAL AVE, OWINGS MILLS, MD 21117-3994
(860) 371-7067
Mailing address
10201 GRAND CENTRAL AVE, OWINGS MILLS, MD 21117-3994
(860) 371-7067
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
SP023111
PA
363LP2300X
Primary Care Nurse Practitioner
SP017427
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SP017427
—
PA
Enumeration date
06/11/2017
Last updated
03/24/2026
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