Individual
MRS. PHILLIPA IFEOMA MODEBELU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN/NP
Contact information
Practice address
3701 IRA E WOODS AVE, GRAPEVINE, TX 76051-4213
(866) 389-2727
Mailing address
3701 IRA E WOODS AVE, GRAPEVINE, TX 76051-4213
(866) 389-2727
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP123412
TX
363LF0000X
Family Nurse Practitioner
AP123412
TX
Other
Enumeration date
10/20/2009
Last updated
03/12/2025
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