Individual provider Active NPI

Aanu Elizabeth Olorunsola

  • Psychiatric/Mental Health Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1659926475
Registry record updated Jun 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R210530 Issued in MD
Practice address
2319B Maryland Ave
Baltimore, MD 21218-5010
Phone
(443) 759-5955
Fax
(443) 438-7809
NPI assigned
Aug 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R210530 MD Primary

Addresses

Primary practice location

2319B Maryland Ave
Baltimore, MD 21218-5010

Mailing address

2319B Maryland Ave
Baltimore, MD 21218-5010
Phone (443) 759-5955

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201002000027 MD Practitioner - Nurse Practitioner 9436578911 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2319 B Maryland Ave
Baltimore, MD 21218-5010
Phone (443) 453-6719

3030 Greenmount Ave
Suite 150
Baltimore, MD 21218-6935
Phone (443) 822-2970

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alpha New Hope Health Services CurrentSince Sep 22, 2020 Accepting new patients
Still Waters Health Systems LLC CurrentSince Mar 4, 2025 Accepting new patients
Salvation Multipurpose Community Outreach CurrentSince Jan 1, 2023 Accepting new patients
Still Waters Health Systems LLC CurrentSince Mar 4, 2025 Accepting new patients

Locations

3030 Greenmount Ave
Ste 150
Baltimore, MD 21218
Phone (410) 202-1094

2319 Maryland Ave
#B
Baltimore, MD 21218
Phone (443) 453-6719

2319 Maryland Ave
Baltimore, MD 21218
Phone (443) 438-7610

417 Eastern Blvd
#1-2
Essex, MD 21221
Phone (443) 453-6719

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1565222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1659926475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2319B MARYLAND AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212185010",
            "telephone_number": "443-759-5955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2319B MARYLAND AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212185010",
            "telephone_number": "443-759-5955",
            "fax_number": "443-438-7809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLORUNSOLA",
        "first_name": "AANU",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-08",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R210530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.