Provider Demographics
NPI:1386832095
Name:AWONIYI-OBRIMAH, DEBORAH (RNC)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:AWONIYI-OBRIMAH
Suffix:
Gender:F
Credentials:RNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3370 S TEXAS AVE
Mailing Address - Street 2:SUITE G
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-3127
Mailing Address - Country:US
Mailing Address - Phone:979-575-1780
Mailing Address - Fax:
Practice Address - Street 1:3370 S TEXAS AVE
Practice Address - Street 2:SUITE G
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-3127
Practice Address - Country:US
Practice Address - Phone:979-575-1780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX747884363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health