Healthcare Provider Details

I. General information

NPI: 1043700719
Provider Name (Legal Business Name): OSARENOMA BLESSING OGBEIDE APRN,PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: OSARENOMA BLESSING OGBEIDE APRN,PMHNP-BC

II. Dates (important events)

Enumeration Date: 05/17/2018
Last Update Date: 07/16/2024
Certification Date: 07/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24974 JESSAMINE MEADOW TRL
RICHMOND TX
77406
US

IV. Provider business mailing address

24974 JESSAMINE MEADOW TRL
RICHMOND TX
77406-2870
US

V. Phone/Fax

Practice location:
  • Phone: 832-398-8867
  • Fax:
Mailing address:
  • Phone: 832-398-8867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1165349
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: