Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | AP141288 | TX |
NPI | 1003475682 |
---|---|
Provider Name | Ms. Rachel A Oyejide |
First Address | Fort Worth, TX 76123-2569 |
Second Address | Fort Worth, TX 76123-2569 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2019 |
Last Update Date | 07/06/2019 |