| Doctor Name: | MRS. OLUWATOYIN CLARA ADISA |
| NPI Number: | 1013156181 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ACNP |
| License Number: | 0024171618 |
| Business Practice Address: | 4726 Avatar Ln Owings Mills, MD - 211177400 |
| Business Phone Number: | 4436292282 |
| Business Fax Number: | 4436292282 |
| Mailing Address: | 4726 Avatar Ln, OWINGS MILLS |
| State: | MD |
| Postal Code: | 211177400 |
| Phone Number: | 4436292282 |
| Fax Number: | |
| NPI Enumeration Date: | 02/13/2009 |
| NPI Last Update Date: | 04/09/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2100X |
| License Number: | 0024171618 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Acute Care |
| Taxonomy Definition: | |