Provider Demographics
NPI:1790598522
Name:OLADEJO, BRIDGET EFOSA (NP)
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:EFOSA
Last Name:OLADEJO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4303 SALLY CT
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-4845
Mailing Address - Country:US
Mailing Address - Phone:817-874-0932
Mailing Address - Fax:
Practice Address - Street 1:4303 SALLY CT
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-4845
Practice Address - Country:US
Practice Address - Phone:817-874-0932
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1036142363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care