Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | AP127791 | TX |
Y | 363LP2300X | Nurse Practitioner - Primary Care | 697530 | TX |
NPI | 1023496726 |
---|---|
Provider Name | Odiri O Akushe |
First Address | Richmond, TX 77406-8096 |
Second Address | Richmond, TX 77406-8096 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2015 |
Last Update Date | 10/08/2021 |