Provider Demographics
NPI:1164292041
Name:ARIYO, DUPE OGUNYEMI (DUPE ARIYO APRN)
Entity Type:Individual
Prefix:
First Name:DUPE
Middle Name:OGUNYEMI
Last Name:ARIYO
Suffix:
Gender:F
Credentials:DUPE ARIYO APRN
Other - Prefix:
Other - First Name:DUPE
Other - Middle Name:OGUNYEMI
Other - Last Name:ARIYO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DUPE ARIYO APRN
Mailing Address - Street 1:917 BENTWOOD TRL
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-4702
Mailing Address - Country:US
Mailing Address - Phone:817-987-3031
Mailing Address - Fax:
Practice Address - Street 1:100 N LAMAR ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76196-0216
Practice Address - Country:US
Practice Address - Phone:817-437-5397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-03
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1145001363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health