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Individual
LILLYKUTTY ABRAHAM MODOOR
Active
Individual
LILLYKUTTY ABRAHAM MODOOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
5004280
NC
363LF0000X
Family Nurse Practitioner
5004280
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5004280
NC
Other
Enumeration date
01/30/2009
Last updated
02/06/2023
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