Provider Demographics
NPI:1568076016
Name:ROTIMI, ADESEWA ELIZABETH (APRN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:ADESEWA
Middle Name:ELIZABETH
Last Name:ROTIMI
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:ADESEWA
Other - Middle Name:
Other - Last Name:ROTIMI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN, PMHNP-BC
Mailing Address - Street 1:803 COOL CUCUMBER WAY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-2817
Mailing Address - Country:US
Mailing Address - Phone:832-933-4303
Mailing Address - Fax:
Practice Address - Street 1:803 COOL CUCUMBER WAY
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-2817
Practice Address - Country:US
Practice Address - Phone:281-736-2979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-02
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX975469163W00000X
TX1118635363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse