Individual provider · NPI-1

Fawazat Maria Agoro, PMHNP

Nurse Practitioner, Psych/Mental Health · Providence, RI

NPI number1134849334
StatusActive
Last updated in NPPESSep 11, 2026

Details

NPI
1134849334
Entity type
Individual (NPI-1)
Name
Ms. Fawazat Maria Agoro
Credential
PMHNP
Sex
Female
Sole proprietor
No
Enumeration date
Aug 30, 2022
Certification date
Sep 11, 2026
Last updated
Sep 11, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LP0808X Nurse Practitioner, Psych/Mental HealthAPRN04593RIYes
363LF0000X Nurse Practitioner, FamilyAPRN03235RI

Practice location

1075 Smith St
Providence, RI 02908-2700

Phone 401-369-9224

Mailing address

1075 Smith St Ste 2
Providence, RI 02908-2700

Other practice locations

1300 Division Rd Ste 301
West Warwick, RI 02893-7558

Phone 401-369-9224

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