Individual
MISS PAULA YETUNDA EBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4545 FULLER DR STE 325, IRVING, TX 75038-6530
(214) 984-2168
Mailing address
PO BOX 1239, TROY, MI 48099-1239
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP120082
TX
363LF0000X
Family Nurse Practitioner
738344
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
332451902
—
TX
Enumeration date
04/10/2011
Last updated
12/28/2021
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