Individual
EBELE OYIBO MBELEDOGU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP,FNP-BC, PMHNP-BC
Contact information
Practice address
121 DOWNEY AVE, MODESTO, CA 95354-1208
(209) 341-1824
Mailing address
2501 MCHENRY AVE, STE F, MODESTO, CA 95350-3257
(812) 205-6598
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
95001325
CA
363LF0000X
Family Nurse Practitioner
95001325
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95024378
CA
363LP2300X
Primary Care Nurse Practitioner
95001325
CA
363LW0102X
Women's Health Nurse Practitioner
95001325
CA
Other
Enumeration date
11/26/2014
Last updated
02/10/2023
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