Provider Demographics
NPI:1336855543
Name:UGWUEGBU, JANIE NNENNE
Entity type:Individual
Prefix:
First Name:JANIE
Middle Name:NNENNE
Last Name:UGWUEGBU
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:249 NC-54 STE 320
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713
Mailing Address - Country:US
Mailing Address - Phone:919-907-3334
Mailing Address - Fax:
Practice Address - Street 1:249 NC-54 STE 320
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713
Practice Address - Country:US
Practice Address - Phone:919-907-3334
Practice Address - Fax:919-321-1825
Is Sole Proprietor?:No
Enumeration Date:2023-01-31
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5017545363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health