Healthcare Provider Details

I. General information

NPI: 1023922556
Provider Name (Legal Business Name): NEW NAME BORN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

232 E FRANKLIN ST
ROCKINGHAM NC
28379-3627
US

IV. Provider business mailing address

232 E FRANKLIN ST
ROCKINGHAM NC
28379-3627
US

V. Phone/Fax

Practice location:
  • Phone: 472-248-0914
  • Fax: 472-279-1220
Mailing address:
  • Phone: 472-248-0914
  • Fax: 472-279-1220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: CYPRIEL FIDELIS NWAFOR
Title or Position: OWNER
Credential:
Phone: 704-777-5710