Healthcare Provider Details

I. General information

NPI: 1851039671
Provider Name (Legal Business Name): CAROL YVONNE OYENUGA APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2022
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1151 W 9TH ST
RUSSELLVILLE KY
42276-9760
US

IV. Provider business mailing address

1151 W 9TH ST
RUSSELLVILLE KY
42276-9760
US

V. Phone/Fax

Practice location:
  • Phone: 270-847-4033
  • Fax: 270-847-4151
Mailing address:
  • Phone: 270-847-4033
  • Fax: 270-847-4151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3015735
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0032983
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1054400
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3952
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: