Provider Demographics
NPI:1457952319
Name:OSHOBA, OLUFUNKE OYINDAMOLA (FNP)
Entity Type:Individual
Prefix:MRS
First Name:OLUFUNKE
Middle Name:OYINDAMOLA
Last Name:OSHOBA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2340 E TRINITY MILLS RD STE 250
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-1946
Mailing Address - Country:US
Mailing Address - Phone:855-893-5637
Mailing Address - Fax:817-666-3873
Practice Address - Street 1:1752 BROAD PARK CIR N STE 114
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-7824
Practice Address - Country:US
Practice Address - Phone:855-893-5637
Practice Address - Fax:817-666-3873
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1016994363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty