Oluwakemi Victoria Fatokimi, PMHNP-BC

Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Jessup, MD

NPI 1932073145 · NPPES record last updated Oct 1, 2025

Key facts

NPI
1932073145
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
License
R248478 (MD)
Practice address
7555 Waterloo Rd
Jessup, MD 20794-9783
Phone
(410) 799-3400
NPI assigned
Oct 1, 2025
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
R248478MDMDPsychiatric/Mental Health Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner
Group: 193400000X SINGLE SPECIALTY GROUP
363LP0808X R248478 MD Yes

Addresses

Primary practice location

7555 Waterloo Rd
Jessup, MD 20794-9783

Mailing address

100 Washington Ave S Ste 900
Minneapolis, MN 55401-2455

Other providers in Jessup, MD

All providers in Jessup, MD · Psychiatric/Mental Health Nurse Practitioner in Maryland

Sources for this page

Verify at the official NPI Registry.