Healthcare Provider Details

I. General information

NPI: 1336910843
Provider Name (Legal Business Name): TOYIN OGUNNIYI PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2024
Last Update Date: 01/12/2024
Certification Date: 01/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4004 GRAPEVINE LOOP
SMYRNA TN
37167-1238
US

IV. Provider business mailing address

4004 GRAPEVINE LOOP
SMYRNA TN
37167-1238
US

V. Phone/Fax

Practice location:
  • Phone: 615-631-3987
  • Fax:
Mailing address:
  • Phone: 615-631-3987
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number34813
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: