Provider Demographics
NPI:1376183442
Name:OSANMOH, SHEBNA NWAYOBUIJE I (PMHNP-BC)
Entity type:Individual
Prefix:MR
First Name:SHEBNA
Middle Name:NWAYOBUIJE
Last Name:OSANMOH
Suffix:I
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3432 WAVECREST LN
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76208-1129
Mailing Address - Country:US
Mailing Address - Phone:901-569-9715
Mailing Address - Fax:940-218-6184
Practice Address - Street 1:405 STATE HIGHWAY 121 BYP STE A250
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-4183
Practice Address - Country:US
Practice Address - Phone:469-946-7897
Practice Address - Fax:650-590-4938
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-07
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXAP144489363LP0808X
CANP95016098363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty