Provider Demographics
NPI:1003243379
Name:ONONOGBU, OLAYEMI (APRN, FNP-C, PMHNP-B)
Entity Type:Individual
Prefix:MS
First Name:OLAYEMI
Middle Name:
Last Name:ONONOGBU
Suffix:
Gender:F
Credentials:APRN, FNP-C, PMHNP-B
Other - Prefix:
Other - First Name:OLAYEMI
Other - Middle Name:
Other - Last Name:OMOTOSO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1305 AIRPORT FWY
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-6605
Mailing Address - Country:US
Mailing Address - Phone:817-358-5800
Mailing Address - Fax:
Practice Address - Street 1:1305 AIRPORT FWY STE 220
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-6606
Practice Address - Country:US
Practice Address - Phone:817-358-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-02
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX771299363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily