MEDICARE: ANTONINE AKINYEMI RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WM0705X	Medical-Surgical Registered Nurse	88-2002	TX

General Provider Information

NPI Number	:	1134058373
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTONINE AKINYEMI RN

Provider Business Mailing Address
First Line	:	9102 SPHINX AVE APT 7101
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76177-3033
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9102 SPHINX AVE APT 7101
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76177-3033
Country	:	US
Telephone Number	:	845-641-5973
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/14/2026
Last Update Date	:	05/14/2026

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