Provider Demographics
NPI:1902586043
Name:EFFRAIM, OLUWASEYI OLUWASEUN (MPH MSN CRNP PMHNP)
Entity Type:Individual
Prefix:MRS
First Name:OLUWASEYI
Middle Name:OLUWASEUN
Last Name:EFFRAIM
Suffix:
Gender:F
Credentials:MPH MSN CRNP PMHNP
Other - Prefix:
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Mailing Address - Street 1:1000 GERMANTOWN PIKE STE B1
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-2482
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7516 CITY AVE STE 7&8
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19151-2102
Practice Address - Country:US
Practice Address - Phone:484-383-2710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASP027883363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health