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NPI Code Detail

MEDICARE: ADESUWA AIBANGBEE NP

MEDICARE:   ADESUWA  AIBANGBEE  NP
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
1363L00000XNurse Practitioner1012194TX

General Provider Information

NPI Number : 1396039871
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADESUWA AIBANGBEE NP
Provider Business Mailing Address
First Line : 19400 W BELLFORT ST APT 3316
Second Line :
City : RICHMOND
State : TX
Zip : 77407-8211
Country : US
Telephone Number : 203-818-3020
Fax Number :
Provider Business Practice Location Address
First Line : 19400 W BELLFORT ST APT 3316
Second Line :
City : RICHMOND
State : TX
Zip : 77407-8211
Country : US
Telephone Number : 203-818-3020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2011
Last Update Date : 06/10/2021

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Directions to “ ADESUWA AIBANGBEE NP” Practice Location

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