Provider Demographics
NPI:1447648191
Name:AWOSOGBA, ESTHER OLAYINKA
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:OLAYINKA
Last Name:AWOSOGBA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 DAJA LN APT 1306
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75050-7651
Mailing Address - Country:US
Mailing Address - Phone:347-335-4884
Mailing Address - Fax:
Practice Address - Street 1:821 POPPIE LN
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:TX
Practice Address - Zip Code:76065-2798
Practice Address - Country:US
Practice Address - Phone:347-335-4884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-05
Last Update Date:2024-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY343451850813E374T00000X, 376K00000X, 376K00000X, 376K00000X
NY00463038374U00000X, 376J00000X, 374U00000X, 376J00000X
TX1045895163W00000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No374T00000XNursing Service Related ProvidersReligious Nonmedical Nursing Personnel
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker
Yes163W00000XNursing Service ProvidersRegistered Nurse