MODUPEOLA BRISIBE

MARIETTA, GA
NPI1376993519
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: GA  RN192902)
Additional Taxonomies363LF0000X Nurse Practitioner, Family
(Licence: GA  192602)
Enumeration Date2016-06-19
Last Update Date2025-04-17
Business Address
MODUPEOLA BRISIBE
280 COBB PKWY S STE 60
MARIETTA, GA 30060-6531
Phone number: 888-663-6331
Mailing Address
MODUPEOLA BRISIBE
2145 WILMINGTON CIR NE
MARIETTA, GA 30062-1694
Phone number: 678-570-9637