NPI 1063483774 · live from the CMS NPI Registry
Kerry Agnello, D.O.
Family Medicine in Fort Bragg, NC. National Provider Identifier 1063483774, active.
NPI record
| NPI | 1063483774 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Family Medicine 207Q00000X |
| Practice location | 2817 Rock Merritt Ave, Fort Bragg, NC 28310 |
| Practice phone | 910-907-8922 |
| Enumerated | January 30, 2006 |
| Last updated | December 3, 2025 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine primary | 207Q00000X | 2011-01723 (NC) |
| Family Medicine | 207Q00000X | 25MB07942900 (NJ) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.