Provider Demographics
NPI:1053589028
Name:AGAJELU, NORA NWAKEGO (CRNP)
Entity type:Individual
Prefix:
First Name:NORA
Middle Name:NWAKEGO
Last Name:AGAJELU
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:85 KINDRED WAY
Mailing Address - Street 2:APT 101
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-5246
Mailing Address - Country:US
Mailing Address - Phone:410-553-6360
Mailing Address - Fax:410-553-6661
Practice Address - Street 1:85 KINDRED WAY
Practice Address - Street 2:APT 101
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-5246
Practice Address - Country:US
Practice Address - Phone:410-553-6360
Practice Address - Fax:410-553-6661
Is Sole Proprietor?:No
Enumeration Date:2008-02-13
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR174033163W00000X, 363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology