Provider Demographics
NPI:1538679147
Name:OSUNDE, EVBU EVELY (RN, BSN, FNP)
Entity type:Individual
Prefix:
First Name:EVBU
Middle Name:EVELY
Last Name:OSUNDE
Suffix:
Gender:F
Credentials:RN, BSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2213 MURPHY DR APT 1916
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-5976
Mailing Address - Country:US
Mailing Address - Phone:972-352-1764
Mailing Address - Fax:
Practice Address - Street 1:1115 E ARKANSAS LANE
Practice Address - Street 2:SUITE B
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76010
Practice Address - Country:US
Practice Address - Phone:817-385-9799
Practice Address - Fax:817-385-9881
Is Sole Proprietor?:No
Enumeration Date:2017-10-10
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP135759363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily