Provider Demographics
NPI:1366070617
Name:ADEPETU, SILIFAT ABEKE
Entity type:Individual
Prefix:
First Name:SILIFAT
Middle Name:ABEKE
Last Name:ADEPETU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SILIFAT
Other - Middle Name:ABEKE
Other - Last Name:ADEPETU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:5802 ANNAPOLIS RD APT 1006
Mailing Address - Street 2:
Mailing Address - City:BLADENSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20710-2077
Mailing Address - Country:US
Mailing Address - Phone:301-531-0475
Mailing Address - Fax:
Practice Address - Street 1:5802 ANNAPOLIS RD APT 1006
Practice Address - Street 2:
Practice Address - City:BLADENSBURG
Practice Address - State:MD
Practice Address - Zip Code:20710-2077
Practice Address - Country:US
Practice Address - Phone:301-531-0475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-31
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR203840363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health