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General NPI Number Information
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NPI Number | 1659897130
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Entity Type | Individual
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Provider Name | NKEM AGATHA NWAOBI DNP, FNP-C, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/16/2017
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Last Update Date | 11/02/2024
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Provider Practice Location Address
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Address Line | 6960 RENO CIRCLE
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City | BEAUMONT
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State | TX
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Zip | 77708-3593
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Country | US
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Telephone | 409-234-9888
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Fax |
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Provider Business Mailing Address
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Address Line | 6960 RENO CIR
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City | BEAUMONT
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State | TX
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Zip | 77708-3593
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Country | US
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Telephone | 409-924-0275
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Fax |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP134846
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP134846
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License Number State | TX
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