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Elizabeth Ire Olumese

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

7375 Executive Pl Ste 400, Lanham, MD 20706-6232

PECOS Enrollment

This provider is enrolled in PECOS as ELIZABETH OLUMESE.

Based on the most recent information from CMS, provider Elizabeth Ire Olumese is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records today at 10:04 AM.

Profile Details

Provider ID
1164758603
Provider Type
Individual
Full Name
Olumese, Elizabeth Ire
Gender
Female

Sole Proprietor
No
Enumeration Date
10/18/2009
Last Updated
1/12/2024

Contact Information

Practice Location

7375 Executive Pl Ste 400, Lanham, MD 20706-6232

(202) 723-4392

Unlisted Fax

Mailing Location

7375 Executive Pl Ste 400, Lanham, MD 20706-6232

(202) 723-4392

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LP0808X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License R131054 Maryland
Code 363LF0000X	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License RN65222 District of Columbia

Elizabeth Ire Olumese

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

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