Provider Demographics
NPI:1053659987
Name:ADEBOWALE, YEMI (PMHNP)
Entity type:Individual
Prefix:
First Name:YEMI
Middle Name:
Last Name:ADEBOWALE
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 LINDBERG AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-2920
Mailing Address - Country:US
Mailing Address - Phone:956-668-0655
Mailing Address - Fax:956-668-0943
Practice Address - Street 1:236 LINDBERG AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-2920
Practice Address - Country:US
Practice Address - Phone:956-668-0655
Practice Address - Fax:956-668-0943
Is Sole Proprietor?:No
Enumeration Date:2013-01-28
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX770332363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX770332OtherTEXAS STATE BOARD OF NURSING