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Individual

ELIZABETH ADEBAYO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1709 MARTIN LUTHER KING JR BLVD STE C, DALLAS, TX 75215-3282
(469) 256-4063
Mailing address
1709 MARTIN LUTHER KING JR BLVD STE C, DALLAS, TX 75215-3282
(469) 256-4063
(469) 305-7422

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
807558
TX
363LF0000X
Family Nurse Practitioner
AP141489
TX
363LP2300X
Primary Care Nurse Practitioner
Primary
AP141489
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1659871168
MEDICARE
Enumeration date
02/20/2018
Last updated
01/19/2022
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