Provider Demographics
NPI:1205374865
Name:AGUNOBI, RITA NKEM (FNP-BC, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:NKEM
Last Name:AGUNOBI
Suffix:
Gender:F
Credentials:FNP-BC, PMHNP-BC
Other - Prefix:
Other - First Name:RITA
Other - Middle Name:NKEM
Other - Last Name:ANENE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN, FNP-BC, PMHNP
Mailing Address - Street 1:5820 MOUNTAIN POINT LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28216-7754
Mailing Address - Country:US
Mailing Address - Phone:704-918-0587
Mailing Address - Fax:
Practice Address - Street 1:111 HARRELSON RD
Practice Address - Street 2:
Practice Address - City:CHERRYVILLE
Practice Address - State:NC
Practice Address - Zip Code:28021-9541
Practice Address - Country:US
Practice Address - Phone:276-601-6197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-03
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC219980363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily