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Modupeola Brisibe
Family Nurse Practitioner in Marietta, Georgia
NPI 1376993519

Modupeola Brisibe is a Family Nurse Practitioner based in Marietta, GA and is specialized in Family. Modupeola Brisibe practices in Marietta, GA. The NPI Number for Modupeola Brisibe is 1376993519 and holds a License No. 192602 (Georgia).

The current practice location address for Modupeola Brisibe is 100 Piedmont Rd, Marietta, GA and can be reached out via phone at 866-389-2727.

Location: 100 Piedmont Rd, Marietta, GA, 30062-1694
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1376993519
Provider Name
Modupeola Brisibe
Credential
Provider Entity Type
Individual
Gender
Female
Address
100 Piedmont Rd, Marietta, GA, 30062-1694
Phone Number
866-389-2727
Fax Number
Provider Enumeration Date
06/19/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
100 Piedmont Rd
City
Marietta
State
Georgia
Zip
30066-3636
Phone Number
866-389-2727
Fax Number
person
Provider Business Mailing Address Details
Address
100 Piedmont Rd
City
Marietta
State
Georgia
Zip
30066-3636
Phone Number
866-389-2727
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
192602 (Georgia)
Definition
Definition to come...
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