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General NPI Number Information
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NPI Number | 1396201620
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Entity Type | Individual
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Provider Name | CLARISE NYENTY AGBOR FNP-C
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Gender | Female
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Dates
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Enumeration Date | 02/12/2019
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Last Update Date | 05/15/2025
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Provider Practice Location Address
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Address Line | 1326 S 14TH ST STE D-D1
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City | ABILENE
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State | TX
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Zip | 79602-3743
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Country | US
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Telephone | 325-352-0148
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Fax |
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Provider Business Mailing Address
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Address Line | 702 MOSSY OAK DR
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City | ABILENE
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State | TX
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Zip | 79602-7060
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Country | US
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Telephone | 646-391-2990
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Fax | 325-275-7931
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP140578
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | AP140578
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License Number State | TX
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