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General NPI Number Information
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NPI Number | 1881459980
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Entity Type | Individual
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Provider Name | HENOK MULUGETA DENBOBA PMHNP
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Gender | Male
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Dates
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Enumeration Date | 02/19/2024
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 311 JUDGES RD STE 4E
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City | WILMINGTON
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State | NC
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Zip | 28405-3655
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Country | US
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Telephone | 910-791-6767
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Fax | 910-399-2190
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Provider Business Mailing Address
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Address Line | 869 LANGSTON TRCE
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City | STONE MOUNTAIN
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State | GA
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Zip | 30083-2498
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Country | US
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Telephone | 404-740-5872
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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 | RN770214
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 5021351
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License Number State | NC
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