Provider Demographics
NPI:1760960868
Name:OBENOFUNDE, FLORENCE E (LVN)
Entity Type:Individual
Prefix:
First Name:FLORENCE
Middle Name:E
Last Name:OBENOFUNDE
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22523 MIRAMAR BEND DR
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-1215
Mailing Address - Country:US
Mailing Address - Phone:405-361-6868
Mailing Address - Fax:
Practice Address - Street 1:22523 MIRAMAR BEND DR
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-1215
Practice Address - Country:US
Practice Address - Phone:405-361-6868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-31
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX336782164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse