Healthcare Provider Details

I. General information

NPI: 1821036849
Provider Name (Legal Business Name): NONYE T AGHANYA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 12/13/2024
Certification Date: 04/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6225 BRANDON AVE SUITE 365
SPRINGFIELD VA
22150-2526
US

IV. Provider business mailing address

500 KIRTS BLVD
TROY MI
48084
US

V. Phone/Fax

Practice location:
  • Phone: 571-642-3433
  • Fax: 855-998-8571
Mailing address:
  • Phone: 248-266-4200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ00007400
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024169458
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: