Provider Demographics
NPI:1881127603
Name:ADEOYE, FUNMILAYO SUSAN (FNP-BC)
Entity type:Individual
Prefix:
First Name:FUNMILAYO
Middle Name:SUSAN
Last Name:ADEOYE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7310 AUTUMN ASPEN LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-7824
Mailing Address - Country:US
Mailing Address - Phone:832-236-9732
Mailing Address - Fax:
Practice Address - Street 1:7310 AUTUMN ASPEN LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-7824
Practice Address - Country:US
Practice Address - Phone:832-236-9732
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-07
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP133492363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner