Provider Demographics
NPI:1346444783
Name:AWE, FOLASHADE ADETOUN (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:FOLASHADE
Middle Name:ADETOUN
Last Name:AWE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NE 410 VA CBOC 2391 NE LOOP 410 SUITE 313
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217
Mailing Address - Country:US
Mailing Address - Phone:830-569-8940
Mailing Address - Fax:830-569-8527
Practice Address - Street 1:NE 410 VA CBOC. 2391 NE LOOP 410 SUITE 313
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217
Practice Address - Country:US
Practice Address - Phone:830-772-9865
Practice Address - Fax:830-772-9821
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-11
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP128965363LF0000X, 363LF0000X
DCRN1005318163W00000X
MDR168495363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse