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General NPI Number Information
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NPI Number | 1790499291
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Entity Type | Individual
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Provider Name | ANITA NGO NP
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Gender | Female
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Dates
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Enumeration Date | 01/09/2023
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 2115 S MAIN ST STE A
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City | WAKE FOREST
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State | NC
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Zip | 27587-5011
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Country | US
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Telephone | 919-229-4833
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 1ST AVE N UNIT 3
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City | BIRMINGHAM
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State | AL
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Zip | 35203-1866
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Country | US
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Telephone | 205-545-5088
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5021583
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License Number State | NC
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