Provider Demographics
NPI:1053802496
Name:AKPOBOME, PATIENCE AFOKAILU (FNP NP-C)
Entity type:Individual
Prefix:
First Name:PATIENCE
Middle Name:AFOKAILU
Last Name:AKPOBOME
Suffix:
Gender:F
Credentials:FNP NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 FARR ST
Mailing Address - Street 2:
Mailing Address - City:WALLER
Mailing Address - State:TX
Mailing Address - Zip Code:77484-8486
Mailing Address - Country:US
Mailing Address - Phone:936-372-3003
Mailing Address - Fax:936-372-8070
Practice Address - Street 1:1225 FARR ST
Practice Address - Street 2:
Practice Address - City:WALLER
Practice Address - State:TX
Practice Address - Zip Code:77484-8486
Practice Address - Country:US
Practice Address - Phone:936-372-3003
Practice Address - Fax:936-372-8070
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-22
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF04180278363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily