TEARRA BREEZE OBAFOLAHAN (APRN) – Licensed Practical Nurse, NPI 1003140575

TEARRA BREEZE OBAFOLAHAN (APRN) is a healthcare provider. based in Toledo, Ohio. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN. They hold a License No. APRN.CNP.0036369 (OH). The NPI Number for TEARRA BREEZE OBAFOLAHAN (APRN) is 1003140575

Main info

Female
Sole Proprietor
3 Years Of Experience
Accepts Medicare Assignment
Name
TEARRA BREEZE OBAFOLAHAN (APRN)
NPI
1003140575
Phone
(567) 298-2344
Address
6916 CLOISTER RD
Enumeration Date
30 September 2009
Last Update Date
7 May 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5674082002
Graduation Year
2023 (3 years ago)
PAC ID
2466988100
Group Practice PAC ID
7416365630
Professional Enrollment ID
I20241205000744
Address ID
OH436063895TO2142XBLVD400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience61
Completeness75
Years active:16State licenses:1Digital endpointsOther names

14,984 NURSE PRACTITIONER in OH

Provider Addresses for TEARRA BREEZE OBAFOLAHAN (APRN)

  • 6916 CLOISTER RD

    TOLEDO, OH 436172206

    Phone: (567) 298-2344

    Type: Mailing

  • 1132, Mackow Drive, Secor Gardens, Vulcan, Toledo, Lucas County, Ohio, 43607, United States

    TOLEDO, OH 436073062

    Phone: (419) 215-3759

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-12-05

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241205000744INurse PractitionerOHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 43617)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7416365630View full group profile
NameSpecialtyState
Emergency MedicineOH
Physician AssistantOH
Emergency MedicineOH
Nurse PractitionerOH
Emergency MedicineOH
Emergency MedicineMI
Emergency MedicineOH
Emergency MedicineOH
Emergency MedicineOH
Nurse PractitionerOH

Reviews

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Frequently asked questions

Is there an official ID for TEARRA BREEZE OBAFOLAHAN (APRN) in U.S. healthcare records?
The official identifier for TEARRA BREEZE OBAFOLAHAN (APRN) is NPI 1003140575.
Would TEARRA BREEZE OBAFOLAHAN (APRN) appear as active to a payer?
You can treat TEARRA BREEZE OBAFOLAHAN (APRN) as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with TEARRA BREEZE OBAFOLAHAN (APRN)?
TEARRA BREEZE OBAFOLAHAN (APRN)'s record emphasizes Licensed Practical Nurse. Clinical services aligned with this taxonomy classification.
Where in Ohio is TEARRA BREEZE OBAFOLAHAN (APRN) registered?
Use Toledo, Ohio as the headline location for TEARRA BREEZE OBAFOLAHAN (APRN) here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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