Provider Demographics
NPI:1083299606
Name:ROJUGBOKAN, VELVETE DYREEN (RN)
Entity Type:Individual
Prefix:
First Name:VELVETE
Middle Name:DYREEN
Last Name:ROJUGBOKAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2326 N BATTLEBELL RD
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77562-4076
Mailing Address - Country:US
Mailing Address - Phone:281-221-7170
Mailing Address - Fax:
Practice Address - Street 1:3027 MARINA BAY DR
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-2729
Practice Address - Country:US
Practice Address - Phone:281-968-2745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-15
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX510505163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX510505OtherNURSING LICENSE