Itite Oghenevwede Agiri, PMHNP-BC, APRN

Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Temple, TX

NPI 1821719956 · NPPES record last updated Oct 4, 2022

Key facts

NPI
1821719956
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
License
1095632 (TX)
Practice address
1901 Veterans Memorial Dr
Temple, TX 76504-7451
Phone
(254) 778-4811
NPI assigned
Sep 7, 2022
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
760674TXMDAdult Psychiatric/Mental Health Registered Nurse
1095632TXMDPsychiatric/Mental Health Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X 760674 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1095632 TX Yes

Addresses

Primary practice location

1901 Veterans Memorial Dr
Temple, TX 76504-7451

Mailing address

13421 Lismore LN
Pflugerville, TX 78660-5679
Phone (972) 536-3690

Other providers in Temple, TX

All providers in Temple, TX · Psychiatric/Mental Health Nurse Practitioner in Texas

Sources for this page

Verify at the official NPI Registry.