MUTIAT O. POPOOLA (NPI# 1477169936) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477169936 |
| Entity Type | Individual |
| Full Name | MUTIAT O. POPOOLA |
| Credential | NURSE PRACTITIONER |
| Practice Address |
15518 Kennett Square Way Brandywine MD 20613-6239 |
| Practice Telephone | 2409883779 |
| Mailing Telephone | 2409883779 |
| Enumeration Date | 2020-09-21 |
| Last Update Date | 2020-09-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
R205702 | MD | Nursing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OPTIONAL | NONE | 01 |
| Street Address |
15518 KENNETT SQUARE WAY |
| City | BRANDYWINE |
| State | MD |
| Zip Code | 20613-6239 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689176018 | Joseph Delonte Snider | Social Worker | 15912 Crain Hwy Ste B174, Brandywine, MD 20613 | 2018-03-01 |
| 1881104065 | Ally Infusion, LLC | Clinic/Center | 7651 Matapeake Bus Dr Ste 103, Brandywine, MD 20613 | 2017-10-02 |
| 1619418001 | Delante Mckinnon | Home Health Aide | 13306 Craine Hwy, Brandywine, MD 20613 | 2017-03-17 |
| 1346604295 | Physician Imaging of Washington Hospital Center, LLC | Radiology | 13950 Bradywine Road, Brandywine, MD 20613 | 2016-04-07 |
| 1053779116 | Medstar Surgery Center At Brandywine, LLC | Clinic/Center | 13950 Brandywine Road, Suite 100, Brandywine, MD 20613 | 2016-02-04 |
| 1649654948 | Innersense Behavioral Health, Inc. | Counselor | 13508 Stoney Creek Lane, Brandywine, MD 20613 | 2015-07-16 |
| 1043588817 | Neibauer Dental Care, PC | Dentist | 7651 Matapeake Business Drive Suite 106, Brandywine, MD 20613 | 2011-12-08 |
| 1376829804 | Danielle Lasure-bryant | Counselor | 11600 Cedarville Road, Brandywine, MD 20613 | 2011-10-28 |
| 1164664405 | Adenike Olayinka Gbenle | Dentist | 7450 Clymer Dr, Brandywine, MD 20613 | 2009-04-01 |
| 1841466919 | Communit Support System 'css LLC'. | Home Health | 6307 Brechib Dr, Brandywine, MD 20613 | 2008-05-07 |
| Find all providers in zip 20613 | ||||
| Taxonomy Code | 163WP0808X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740805613 | Nwamaka F Ezike | Registered Nurse | 913 Lake Shore Dr, Bowie, MD 20721-2902 | 2020-06-16 |
| 1578185369 | Marion Johnson | Registered Nurse | 9633 Clocktower Ln, Columbia, MD 21046-1877 | 2020-05-14 |
| 1245868009 | Shantiah Shanee Norfleet | Registered Nurse | 7681 Colonial Beach Rd, Pasadena, MD 21122-3206 | 2020-03-28 |
| 1710514542 | Gladys Mbah Nebafu | Registered Nurse | 6100 Glenn Dale Rd, Glenn Dale, MD 20769-9211 | 2020-03-23 |
| 1679107478 | Ellen Dieujuste | Registered Nurse | 3719 34th St, Mount Rainier, MD 20712-2149 | 2020-03-02 |
| 1194364588 | Cynthia Ekwutife | Registered Nurse | 2504 Highcrest Ct, Manchester, MD 21102-1413 | 2020-01-02 |
| 1770128712 | Keith J Reilley | Registered Nurse | 101 W Read St Unit B03, Baltimore, MD 21201-4906 | 2019-11-13 |
| 1497390702 | Revision Wellness, LLC | Registered Nurse | 103 Williamsport Cir Ste A, Salisbury, MD 21804-6472 | 2019-11-11 |
| 1396390167 | Linh Van Register | Registered Nurse | 5223 Ilchester Rd, Ellicott City, MD 21043-7041 | 2019-08-07 |
| 1558929745 | Arithia Harden | Registered Nurse | 2569 Oak Glen Way, District Heights, MD 20747-3708 | 2019-06-03 |
| Find all providers with the same taxonomy | ||||
| City | BRANDYWINE |
| Zip Code | 20613 |
Please comment or provide details below to improve the information on MUTIAT O. POPOOLA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.