Provider Demographics
NPI:1659897130
Name:NWAOBI, NKEM AGATHA (DNP, FNP-C, PMHNP-BC)
Entity type:Individual
Prefix:DR
First Name:NKEM
Middle Name:AGATHA
Last Name:NWAOBI
Suffix:
Gender:F
Credentials:DNP, FNP-C, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6960 RENO CIR
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77708-3593
Mailing Address - Country:US
Mailing Address - Phone:409-924-0275
Mailing Address - Fax:
Practice Address - Street 1:6960 RENO CIRCLE
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77708-3593
Practice Address - Country:US
Practice Address - Phone:409-234-9888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-16
Last Update Date:2024-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP134846363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily