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Lillykutty Abraham Modoor, NURSEPRACTITIONER
Psychiatric/Mental Health Nurse Practitioner in Winston Salem, North Carolina
NPI 1013155969

Lillykutty Abraham Modoor is a Psychiatric/Mental Health Nurse Practitioner based in Concord, NC and is specialized in Psychiatric/Mental Health. Lillykutty Abraham Modoor practices in Winston Salem, NC and has the professional credentials of NURSEPRACTITIONER. The NPI Number for Lillykutty Abraham Modoor is 1013155969 and holds a License No. 5004280 (North Carolina).

The current practice location address for Lillykutty Abraham Modoor is 650 Highland Ave Ste 100, Winston Salem, NC and can be reached out via phone at 336-607-8523 and via fax at 336-773-0916.

Location: 650 Highland Ave Ste 100, Winston Salem, NC, 28025-1833
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1013155969
Provider Name
Lillykutty Abraham Modoor
Credential
NURSEPRACTITIONER
Provider Entity Type
Individual
Gender
Female
Address
650 Highland Ave Ste 100, Winston Salem, NC, 28025-1833
Phone Number
336-607-8523
Fax Number
336-773-0916
Provider Enumeration Date
01/30/2009
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
650 Highland Ave Ste 100
City
Winston Salem
State
North Carolina
Zip
27101-4304
Phone Number
336-607-8523
Fax Number
336-773-0916
person
Provider Business Mailing Address Details
Address
650 Highland Ave Ste 100
City
Winston Salem
State
North Carolina
Zip
27101-4304
Phone Number
336-607-8523
Fax Number
336-773-0916
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
-
Taxonomy
363L00000X
License No.
5004280 (North Carolina)
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
5004280 (North Carolina)
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
363LP0808X
License No.
5004280 (North Carolina)
Definition
Definition to come...
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