Provider Demographics
NPI:1134946957
Name:OSAYIMWEN, ODION PATIENCE (NP)
Entity type:Individual
Prefix:
First Name:ODION
Middle Name:PATIENCE
Last Name:OSAYIMWEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ODION
Other - Middle Name:PATIENCE
Other - Last Name:ISIBOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:967 REDAN TRCE
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30088-2562
Mailing Address - Country:US
Mailing Address - Phone:404-723-0018
Mailing Address - Fax:
Practice Address - Street 1:967 REDAN TRCE
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30088-2562
Practice Address - Country:US
Practice Address - Phone:404-723-0018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN251358363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health