Provider Demographics
NPI:1255977526
Name:ONGECHI, JANET KEMUNTO
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:KEMUNTO
Last Name:ONGECHI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7161 REX RD
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-6457
Mailing Address - Country:US
Mailing Address - Phone:763-222-6096
Mailing Address - Fax:
Practice Address - Street 1:410 S JUDD PKWY SE
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-6953
Practice Address - Country:US
Practice Address - Phone:763-222-0963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-21
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC227053363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily