Provider Demographics
NPI:1346461431
Name:NNAJI, NGOZI (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MRS
First Name:NGOZI
Middle Name:
Last Name:NNAJI
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:MRS
Other - First Name:NGOZI
Other - Middle Name:
Other - Last Name:NNAJI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-C
Mailing Address - Street 1:307 WILD LAUREL CT
Mailing Address - Street 2:
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173-6101
Mailing Address - Country:US
Mailing Address - Phone:704-264-6208
Mailing Address - Fax:
Practice Address - Street 1:307 WILD LAUREL CT
Practice Address - Street 2:
Practice Address - City:WAXHAW
Practice Address - State:NC
Practice Address - Zip Code:28173-6101
Practice Address - Country:US
Practice Address - Phone:704-264-6208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC34612081H0002X
NC5008979363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No2081H0002XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6601558Medicaid
NCHC3461OtherLINCENSE NUMBER