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Individual
AJITH ABRAHAM
Active
Individual
AJITH ABRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
284170
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
0024182168
VA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5016227
NC
Other
Enumeration date
07/10/2021
Last updated
01/02/2024
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