Provider Demographics
NPI:1285492017
Name:OYEWOLE, FEYISAYO OLUFUNKE (FNP-BC FNP-C)
Entity type:Individual
Prefix:MRS
First Name:FEYISAYO
Middle Name:OLUFUNKE
Last Name:OYEWOLE
Suffix:
Gender:F
Credentials:FNP-BC FNP-C
Other - Prefix:MRS
Other - First Name:FEYISAYO
Other - Middle Name:OLUFUNKE
Other - Last Name:OYEWOLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ADESONA
Mailing Address - Street 1:2501 W LEHIGH AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19132-3207
Mailing Address - Country:US
Mailing Address - Phone:215-227-0300
Mailing Address - Fax:215-227-0302
Practice Address - Street 1:2501 W LEHIGH AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19132-3207
Practice Address - Country:US
Practice Address - Phone:215-227-0300
Practice Address - Fax:215-227-0302
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-07
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP029409363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty