Provider Demographics
NPI:1770856155
Name:ADIO, YETUNDE ELIZABETH (NP)
Entity Type:Individual
Prefix:
First Name:YETUNDE
Middle Name:ELIZABETH
Last Name:ADIO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:YETUNDE
Other - Middle Name:ELIZABETH
Other - Last Name:OGUNNAIKE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PMHNP
Mailing Address - Street 1:PO BOX 1908
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75403-1908
Mailing Address - Country:US
Mailing Address - Phone:903-455-5986
Mailing Address - Fax:903-454-4621
Practice Address - Street 1:4311 WESLEY ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75401-5639
Practice Address - Country:US
Practice Address - Phone:903-455-5958
Practice Address - Fax:903-454-4514
Is Sole Proprietor?:No
Enumeration Date:2012-02-16
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX776283363LF0000X
TXAP120890363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily