MRS. OLANREWAJU OMOBOLA OLURODE (NPI# 1396304390) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396304390 |
| Entity Type | Individual |
| Full Name | MRS. OLANREWAJU OMOBOLA OLURODE |
| Credential | FNP-C |
| Practice Address |
104 Buckskin Trl Victoria TX 77904-2962 |
| Practice Telephone | 8327542251 |
| Mailing Telephone | 3617886507 |
| Enumeration Date | 2019-06-12 |
| Last Update Date | 2019-06-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
29036 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
104 BUCKSKIN TRL |
| City | VICTORIA |
| State | TX |
| Zip Code | 77904-2962 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528600384 | Bertha P Mendieta | Physician Assistant | Citizens Victoria Surgical Associates, 2705 Hospital Drive Suite 400, Building B, Victoria, TX 77904 | 2019-10-14 |
| 1952968901 | Eliza Welder | Counselor | 6502 Nursery Dr. Suite, Suite 100, Victoria, TX 77904 | 2019-05-24 |
| 1154806529 | Tammy Lynn Hogan | Counselor | 4702 N. Laurent Ste D, Victoria, TX 77904 | 2018-10-01 |
| 1740724939 | Sarah Ritchea | Counselor | 6502 Nursery Dr. Suite 100, Victoria, TX 77904 | 2016-12-07 |
| 1992177489 | World of Words Speech & Feeding Services, LLC | Speech-Language Pathologist | 120 Appaloosa Dr., Victoria, TX 77904 | 2015-10-23 |
| 1396115739 | Katelin Mcvey | Physician Assistant | 106 Springwood Drive, Suite 100, Victoria, TX 77904 | 2015-09-28 |
| 1689070062 | Jeremy M Thompson Dds Ms Pllc | Clinic/Center | 103 Professional Park Driv, Victoria, TX 77904 | 2014-11-12 |
| 1265864144 | Pf Development 23, LLC | Hospice Care, Community Based | 1501 E Mockingbird Ln Ste 301b, Victoria, TX 77904 | 2013-08-02 |
| 1053669762 | Victoria Dentistry, Pllc | Dentist | 8809 North Navarro, Ste.100, Victoria, TX 77904 | 2012-08-28 |
| 1508126442 | Ayo Adu, M.d., Pllc | Family Medicine | 9410 Ne Zac Lentz Parkway, Suite 200, Victoria, TX 77904 | 2012-05-25 |
| Find all providers in zip 77904 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366098915 | Zachary Barber | Nurse Practitioner | 605 E San Antonio St # 509, Victoria, TX 77901-6050 | 2019-08-09 |
| 1780169946 | Kelli Longoria | Nurse Practitioner | 2700 Citizens Plz Ste 400, Victoria, TX 77901-5757 | 2018-10-03 |
| 1497238869 | Crystal Joan Douglas | Nurse Practitioner | 9006 N Navarro St, Victoria, TX 77904-1565 | 2018-09-12 |
| 1790270106 | Jeremiah E Bast | Nurse Practitioner | 605 E San Antonio St Ste 509e, Victoria, TX 77901-6079 | 2018-06-27 |
| 1811488349 | Victoria Np Clinic Pllc | Nurse Practitioner | 606 E. Nueces St, Victoria, TX 77901 | 2018-05-21 |
| 1578913323 | Acadia Matilda Joines | Nurse Practitioner | 104 Watermark, Victoria, TX 77904-1168 | 2016-06-13 |
| 1518337690 | Nikki Reger | Nurse Practitioner | 102 Andrew Dr, Victoria, TX 77904-2938 | 2015-10-01 |
| 1336524974 | Adan Hinojosa Adame | Nurse Practitioner | 102 Contento St, Victoria, TX 77905-0688 | 2015-07-24 |
| 1235522509 | Kristi Williams | Nurse Practitioner | 728 Menke Rd, Victoria, TX 77905-5757 | 2015-03-11 |
| 1346524303 | Pamela Ross Breazeale | Nurse Practitioner | 117 Cumberland Gap, Victoria, TX 77904-2416 | 2011-10-07 |
| Find all providers in VICTORIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.