Healthcare Provider Details

I. General information

NPI: 1386354058
Provider Name (Legal Business Name): MABEL C. OYEWUMI RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2022
Last Update Date: 12/05/2024
Certification Date: 12/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 W WATERLOO RD
AKRON OH
44319-1116
US

IV. Provider business mailing address

3910 ENCELL DR
COPLEY OH
44321-1882
US

V. Phone/Fax

Practice location:
  • Phone: 330-724-7715
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN320582
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN19192
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: