Provider Demographics
NPI:1568974129
Name:OHUOBA, ADESUWA SARAH (PMHNP-BC, FNP-C)
Entity Type:Individual
Prefix:
First Name:ADESUWA
Middle Name:SARAH
Last Name:OHUOBA
Suffix:
Gender:F
Credentials:PMHNP-BC, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20118 BANDERA LAKE LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-1569
Mailing Address - Country:US
Mailing Address - Phone:832-978-9787
Mailing Address - Fax:
Practice Address - Street 1:2831 SAINT ROSE PKWY STE 222
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4840
Practice Address - Country:US
Practice Address - Phone:702-589-4871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-03
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP135186363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1366562225OtherFPW - GROUP
TXAP135186OtherAPRN-CNP