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Individual

MODOU LAMIN JAWO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2301 ERWIN RD, DURHAM, NC 27705-4699
(919) 684-8111
Mailing address
1232 TURKEY TROT RD, WENDELL, NC 27591-6754
(984) 960-7649

Taxonomy

Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
291241
NC
363L00000X
Nurse Practitioner
Primary
5020457
NC
363LA2100X
Acute Care Nurse Practitioner
5020457
NC

Other

Enumeration date
06/03/2024
Last updated
03/06/2025
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