person
Ms. Modupe D Mcintosh, CPNP
Psychiatric/Mental Health Nurse Practitioner in Clearwater, Florida
NPI 1174522916

Modupe D Mcintosh is a Psychiatric/Mental Health Nurse Practitioner based in Lilburn, FL and is specialized in Psychiatric/Mental Health. Modupe D Mcintosh practices in Clearwater, FL and has the professional credentials of CPNP. The NPI Number for Modupe D Mcintosh is 1174522916 and holds a License No. RN092844 (Florida).

The current practice location address for Modupe D Mcintosh is 13577 Feather Sound Dr, Clearwater, FL and can be reached out via phone at 904-902-4408 and via fax at 904-420-4745. You can also correspond with Modupe D Mcintosh through the mailing address at 635 BEAVER RUIN RD NW, LILBURN, GA - 30047-3474 (mailing address contact number: 678-807-2230).

Location: 13577 Feather Sound Dr, Clearwater, FL, 30047-3474
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Provider Profile Details
NPI Number
1174522916
Provider Name
Modupe D Mcintosh
Credential
CPNP
Provider Entity Type
Individual
Gender
Female
Address
13577 Feather Sound Dr, Clearwater, FL, 30047-3474
Phone Number
904-902-4408
Fax Number
904-420-4745
Provider Enumeration Date
07/14/2005
Last Update Date
04/13/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
554500072A 05 GA
554500072D 05 GA
554500072E 05 GA
institution
Provider Business Practice Location Address Details
Address
13577 Feather Sound Dr
City
State
Zip
33762-2258
Phone Number
904-902-4408
Fax Number
904-420-4745
person
Provider Business Mailing Address Details
Address
13577 Feather Sound Dr
City
State
Zip
33762-2258
Phone Number
904-902-4408
Fax Number
904-420-4745
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Pediatrics
Taxonomy
License No.
APRN11031023 (Florida)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
License No.
RN092844 (Georgia)
Definition
Definition to come...
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