Healthcare Provider Details

I. General information

NPI: 1801791868
Provider Name (Legal Business Name): EFE CAROLINE EDOGBO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2026
Last Update Date: 10/10/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2511 ROSEMARY ST
ROSENBERG TX
77469-3490
US

IV. Provider business mailing address

2511 ROSEMARY ST
ROSENBERG TX
77469-3490
US

V. Phone/Fax

Practice location:
  • Phone: 347-869-2952
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1074085
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: