Individual
VIVIAN IJEMABA OSEMENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2203 W 35TH ST, AUSTIN, TX 78703-1203
(512) 454-4731
Mailing address
4219 N SUMMERCREST LOOP, ROUND ROCK, TX 78681-1087
(512) 740-5441
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
888034
TX
Other
Enumeration date
09/03/2024
Last updated
09/03/2024
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