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NPI Code Detail

MEDICARE: JOY OGBIMI

MEDICARE: JOY OGBIMI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAP133008TX

General Provider Information

NPI Number : 1013455930
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOY OGBIMI
Provider Business Mailing Address
First Line : 2922 PEGASUS CT
Second Line :
City : GRAND PRAIRIE
State : TX
Zip : 75052-8042
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2922 PEGASUS CT
Second Line :
City : GRAND PRAIRIE
State : TX
Zip : 75052-8042
Country : US
Telephone Number : 214-809-0542
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2017
Last Update Date : 02/11/2017

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Directions to “ JOY OGBIMI ” Practice Location

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