Provider Demographics
NPI:1992311849
Name:SINANON OYENEYE, NATASHA INESHA (NP)
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:INESHA
Last Name:SINANON OYENEYE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6920 POINTE INVERNESS WAY STE 200
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46804-7934
Mailing Address - Country:US
Mailing Address - Phone:260-479-3514
Mailing Address - Fax:260-479-3520
Practice Address - Street 1:702 VAN BUREN ST
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46802-3697
Practice Address - Country:US
Practice Address - Phone:260-425-3782
Practice Address - Fax:260-425-3783
Is Sole Proprietor?:No
Enumeration Date:2020-09-16
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN71010571A363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN12161988OtherDOB