Provider Demographics
NPI:1801245998
Name:AKINDELE, OLAYEMI CYNTHIA (NP)
Entity type:Individual
Prefix:
First Name:OLAYEMI
Middle Name:CYNTHIA
Last Name:AKINDELE
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 1:12030 KILDAVIE ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-3124
Mailing Address - Country:US
Mailing Address - Phone:832-894-7736
Mailing Address - Fax:
Practice Address - Street 1:71 E WADSWORTH PARK DR
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-8996
Practice Address - Country:US
Practice Address - Phone:832-864-7736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-08
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP131038363L00000X, 363LP0808X
TX804973363L00000X, 363LP0808X
WAAP61228405363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner