Provider Demographics
NPI:1164122008
Name:OYEDELE, ABOSEDE OYERONKE (NP)
Entity Type:Individual
Prefix:MRS
First Name:ABOSEDE
Middle Name:OYERONKE
Last Name:OYEDELE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3208 WILLOW BROOK DR
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-2077
Mailing Address - Country:US
Mailing Address - Phone:256-337-5745
Mailing Address - Fax:
Practice Address - Street 1:3208 WILLOW BROOK DR
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-2077
Practice Address - Country:US
Practice Address - Phone:256-337-5745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-08
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1111790363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health