Individual provider · Type 1 NPI
Omotayo Theresa Gbengaojo, APRN
Psychiatric/Mental Health Nurse Practitioner · Mansfield, TX
NPI number
1972201895
Active
Practice location
1475 Heritage Pkwy Ste 209
Mansfield, TX 76063-2740
Mailing address
1312 Lawnview Dr
Forney, TX 75126-1308
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 1110419 (TX) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1972201895
Omotayo Theresa Gbengaojo, APRN's National Provider Identifier is 1972201895, issued on Feb 20, 2023. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Mansfield, TX. The record was last updated on May 26, 2025.