Provider Demographics
NPI:1053302190
Name:AUGUSTUS, EUNICE OYEDOYIN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:EUNICE
Middle Name:OYEDOYIN
Last Name:AUGUSTUS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 WYNTERHALL RD SE
Mailing Address - Street 2:#D
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35803-7919
Mailing Address - Country:US
Mailing Address - Phone:256-656-1715
Mailing Address - Fax:
Practice Address - Street 1:8208 HIGHWAY 53
Practice Address - Street 2:
Practice Address - City:TONEY
Practice Address - State:AL
Practice Address - Zip Code:35773-8512
Practice Address - Country:US
Practice Address - Phone:256-851-8802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALI-064660363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA50BBJWBMedicare UPIN