Provider Demographics
NPI:1235377805
Name:OYEFESOBI, ADIAH DIONNE (WHNP)
Entity Type:Individual
Prefix:
First Name:ADIAH
Middle Name:DIONNE
Last Name:OYEFESOBI
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:ADIAH
Other - Middle Name:DIONNE
Other - Last Name:NWANKWO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:WHNP
Mailing Address - Street 1:910 BEECH GLEN DR
Mailing Address - Street 2:
Mailing Address - City:MEBANE
Mailing Address - State:NC
Mailing Address - Zip Code:27302-6086
Mailing Address - Country:US
Mailing Address - Phone:336-343-9164
Mailing Address - Fax:336-450-1770
Practice Address - Street 1:114 BRADY CT
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-4554
Practice Address - Country:US
Practice Address - Phone:336-343-9164
Practice Address - Fax:336-450-1770
Is Sole Proprietor?:No
Enumeration Date:2009-02-04
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP117884363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX198502006Medicaid
TX198502007Medicaid
TX198502010Medicaid
TX198502003Medicaid
TX198502004Medicaid
TX198502012Medicaid
TX830N92OtherBCBS
TX198502001Medicaid
TX198502009Medicaid
TX198502002Medicaid
TX198502008Medicaid
TX198502005Medicaid
TX8Y9483OtherBLUE CROSS BLUE SHIELD
TX198502012Medicaid