Provider Demographics
NPI:1548023864
Name:ADEYEMI, JOY OLUWAKEMI (FNP)
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:OLUWAKEMI
Last Name:ADEYEMI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:JOY
Other - Middle Name:
Other - Last Name:ALAOFIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1500 COTTONWOOD CREEK TRL
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-7555
Mailing Address - Country:US
Mailing Address - Phone:570-877-8180
Mailing Address - Fax:
Practice Address - Street 1:501 CIRCLE WAY UNIT 5D
Practice Address - Street 2:
Practice Address - City:JARRELL
Practice Address - State:TX
Practice Address - Zip Code:76537-1917
Practice Address - Country:US
Practice Address - Phone:570-877-8180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1021367363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily