Provider Demographics
NPI:1891315479
Name:OGUNJUMELO, YETUNDE CHRISTIANA (ARPN-CNP)
Entity type:Individual
Prefix:
First Name:YETUNDE
Middle Name:CHRISTIANA
Last Name:OGUNJUMELO
Suffix:
Gender:F
Credentials:ARPN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 WILCREST DR STE 121
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-1642
Mailing Address - Country:US
Mailing Address - Phone:346-388-0388
Mailing Address - Fax:
Practice Address - Street 1:1100 WILCREST DR STE 121
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-1642
Practice Address - Country:US
Practice Address - Phone:346-388-0388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-23
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX936255163W00000X
TX1055946363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse