Individual
BOSEDE EHIOBU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
2912 N MACARTHUR BLVD STE 104, IRVING, TX 75062-4489
(214) 714-5278
Mailing address
2912 N MACARTHUR BLVD STE 104, IRVING, TX 75062-4489
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP141050
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP141050
LICENSE NUMBER
TX
Enumeration date
03/19/2019
Last updated
09/20/2021
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