Provider Demographics
NPI:1760016398
Name:NWANGWU, AGATHA IFEYINWA (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:AGATHA
Middle Name:IFEYINWA
Last Name:NWANGWU
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7406 9TH ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20012-1702
Mailing Address - Country:US
Mailing Address - Phone:301-996-1230
Mailing Address - Fax:
Practice Address - Street 1:7406 9TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-1702
Practice Address - Country:US
Practice Address - Phone:301-996-1230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-22
Last Update Date:2020-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC2019074447363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health