Organization
RENEWED AXIS TELEHEALTH PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NINA FOMBUH FNP-BC (OWNER/PROVIDER)
(047) 741-2909
Entity
Organization
Contact information
Practice address
2101 SARDIS RD N STE 120B, CHARLOTTE, NC 28227-7711
(704) 840-2927
Mailing address
2101 SARDIS RD N STE 120B, CHARLOTTE, NC 28227-7711
(508) 840-2926
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
06/30/2025
Last updated
02/02/2026
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