Healthcare Provider Details

I. General information

NPI: 1851924443
Provider Name (Legal Business Name): RAHEL ADMASSU AYALEW FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2020
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 ZION CHURCH RD E
CONCORD NC
28025-6827
US

IV. Provider business mailing address

4812 MESA VERDE RD
CHARLOTTE NC
28277-3542
US

V. Phone/Fax

Practice location:
  • Phone: 980-440-9170
  • Fax:
Mailing address:
  • Phone: 919-636-0805
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5012877
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number5012877
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5012877
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: