MEDICARE: OLUWAFERANMI JOANAH AFOLABI PMHNP

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
1	163W00000X	Registered Nurse	903815	TX
2	163WH0200X	Home Health Registered Nurse	682451	NY
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	1107104	TX

General Provider Information

NPI Number	:	1881011385
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLUWAFERANMI JOANAH AFOLABI PMHNP

Provider Business Mailing Address
First Line	:	17401 W LAKE HOUSTON PKWY APT 7204
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77346-5147
Country	:	US
Telephone Number	:	281-594-8953
Fax Number	:

Provider Business Practice Location Address
First Line	:	19500 ST HWY 249 STE 120
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-3027
Country	:	US
Telephone Number	:	844-824-8775
Fax Number	:	281-648-2200

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2014
Last Update Date	:	01/02/2025

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