Individual provider · Type 1 NPI
Modupeola Brisibe
Family Nurse Practitioner · Marietta, GA
NPI number
1376993519
Active
Practice location
280 Cobb Pkwy S Ste 60
Marietta, GA 30060-6531
Fax (415) 252-7176
Mailing address
2145 Wilmington Cir NE
Marietta, GA 30062-1694
Other practice locations
- 100 Piedmont Rd, Marietta, GA 30066-3636 · (866) 389-2727
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 192602 (GA) |
| Family Nurse Practitioner Primary | 363LF0000X | RN192902 (GA) |
Family Nurse Practitioner: Definition to come...
2 other providers at this address
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About NPI 1376993519
Modupeola Brisibe's National Provider Identifier is 1376993519, issued on Jun 19, 2016. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Marietta, GA. The record was last updated on Apr 17, 2025.