Provider Demographics
NPI:1821036849
Name:AGHANYA, NONYE T (NP)
Entity type:Individual
Prefix:MRS
First Name:NONYE
Middle Name:T
Last Name:AGHANYA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 KIRTS BLVD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084
Mailing Address - Country:US
Mailing Address - Phone:248-266-4200
Mailing Address - Fax:
Practice Address - Street 1:6225 BRANDON AVE
Practice Address - Street 2:SUITE 365
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150-2526
Practice Address - Country:US
Practice Address - Phone:571-642-3433
Practice Address - Fax:855-998-8571
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00007400363LF0000X
VA0024169458363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ087318Medicare ID - Type Unspecified
NJP77208Medicare UPIN
NJ087318XVAMedicare UPIN