Provider Demographics
NPI:1003475682
Name:OYEJIDE, RACHEL A (NP)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:A
Last Name:OYEJIDE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:RACHEL
Other - Middle Name:A
Other - Last Name:OYEJIDE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:4205 GOLDEN HORN LN
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76123-2569
Mailing Address - Country:US
Mailing Address - Phone:682-333-2250
Mailing Address - Fax:682-333-2250
Practice Address - Street 1:4205 GOLDEN HORN LN
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76123-2569
Practice Address - Country:US
Practice Address - Phone:682-333-2250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-07
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP141288363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty