Individual
MARILY MODESTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP-C
Contact information
Practice address
407 KENT ST, MIDLAND, TX 79701-5858
(432) 687-2273
Mailing address
1407 ALAMOSA ST, ODESSA, TX 79763-2413
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1218347
TX
Other
Enumeration date
12/03/2025
Last updated
12/03/2025
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