CORDELIA ODUNAYO (NPI# 1306325790) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306325790 |
| Entity Type | Individual |
| Full Name | CORDELIA ODUNAYO |
| Credential | PMHNP |
| Practice Address |
300 Pennsylvania Ave Fort Worth TX 76104-3304 |
| Mailing Address |
3303 Weyburn Dr Venus TX 76084-1190 |
| Practice Telephone | 8175694555 |
| Mailing Telephone | 8177036011 |
| Enumeration Date | 2018-08-07 |
| Last Update Date | 2020-05-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
AP138725 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | AP138725 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 110 W Randol Mill Rd Ste 200, Arlington, TX 760114612 | 2148927151 |
| Street Address |
300 PENNSYLVANIA AVE |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76104-3304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972082410 | Ellen I Goodman | Licensed Vocational Nurse | 300 Pennsylvania Ave, Fort Worth, TX 76104-3304 | 2018-08-07 |
| 1396224366 | Kristina M Ward | Social Worker | 300 Pennsylvania Ave, Fort Worth, TX 76104-3304 | 2018-08-10 |
| 1760961064 | Tracy L Reeves | Registered Nurse | 300 Pennsylvania Ave, Fort Worth, TX 76104-3304 | 2018-08-08 |
| 1265911515 | Lisa Gail Dodd | Registered Nurse | 300 Pennsylvania Ave, Fort Worth, TX 76104-3304 | 2018-08-08 |
| 1003250770 | Karla Raquel Lopez Calderon | Psychiatry & Neurology | 300 Pennsylvania Ave, Fort Worth, TX 76104 | 2013-04-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669082186 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 1115 8th St, Fort Worth, TX 76104 | 2020-08-10 |
| 1992343693 | Iris Giove | Psychologist | John Peter Smith Hospital, 1500 S. Main St., Fort Worth, TX 76104 | 2019-12-13 |
| 1104480656 | Swarnalaxmi Umapathy | Student in an Organized Health Care Education/Training Program | 900 8th Avenue, Fort Worth, TX 76104 | 2019-04-30 |
| 1881189132 | Mega Surgical Assistants LLC | Specialist/Technologist, Other | 1301pennsylvania, Fort Worth, TX 76104 | 2018-06-28 |
| 1356848899 | Tricia Kelly | Nurse Practitioner | 1325 Pennsylvania Avenue Suite 560, Fort Worth, TX 76104 | 2018-04-11 |
| 1952820979 | Modern Vein Clinic | Internal Medicine | 757 8th Avenue, Suite A, Forth Worth, TX 76104 | 2017-09-11 |
| 1790207165 | Vanessa Abbood | Dietitian, Registered | 900 Eighth Ave, Fns Department, Fort Worth, TX 76104 | 2017-07-07 |
| 1922537562 | Nicole Marie Tod | Student in an Organized Health Care Education/Training Program | 1500 S Main Street, Fort Worth, TX 76104 | 2017-06-07 |
| 1770025934 | Micah Bonola | Chiropractor | 1300 W. Rosedale St, Ste. A, Fort Worth, TX 76104 | 2016-11-04 |
| 1518315894 | United Bioscience, LLC. | Clinical Medical Laboratory | 901 W. Leuda St., B, Fort Worth, TX 76104 | 2016-05-27 |
| Find all providers in zip 76104 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386257814 | Daniel Oyewusi Oyewole | Nurse Practitioner | 4051 Hunters Creek Dr, Fort Worth, TX 76123-2549 | 2020-08-25 |
| 1174147037 | Ugbodu Ene Awoniyi | Nurse Practitioner | 4924 Cliburn Dr, Fort Worth, TX 76244-6130 | 2020-06-05 |
| 1346863925 | Lynnetta Vanice Cheeks | Nurse Practitioner | 6101 Saddlepack Dr, Fort Worth, TX 76123-1591 | 2020-05-18 |
| 1073143160 | Dorcas Mwangi | Nurse Practitioner | 4809 Campfire Ct, Fort Worth, TX 76244-7922 | 2020-01-17 |
| 1497390686 | Chigane Abraham | Nurse Practitioner | 8609 Glenburne Dr, Fort Worth, TX 76131 | 2019-11-12 |
| 1457895666 | Paul Geise | Nurse Practitioner | 3501 Ne Loop 820, #306, Fort Worth, TX 76137-2415 | 2016-12-06 |
| 1477005007 | Amie Wolverton Riddle | Nurse Practitioner | 320 Silver Canyon Dr, Fort Worth, TX 76108-9612 | 2016-10-31 |
| 1659742211 | Kamesha Roshun Mitchell | Nurse Practitioner | 3100 Hulen St, Fort Worth, TX 76107 | 2015-10-08 |
| 1255592424 | Akosua Serwaa Obeng | Nurse Practitioner | 8949 Silent Brook Ln, Fort Worth, Fort Worth, TX 76244-4946 | 2008-06-20 |
| 1154518470 | Dawn Dean | Nurse Practitioner | 124 Cooks Ln, Fort Worth, TX 76120-2016 | 2007-10-01 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76104 |
Please comment or provide details below to improve the information on CORDELIA ODUNAYO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.