| Doctor Name: | MRS. PHILLIPA IFEOMA MODEBELU |
| NPI Number: | 1053647461 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN/NP |
| License Number: | RN233973 |
| Business Practice Address: | 801 N Tarrant Pkwy Keller, TX - 762486860 |
| Business Phone Number: | 8663892727 |
| Business Fax Number: | |
| Mailing Address: | 801 N Tarrant Pkwy, KELLER |
| State: | TX |
| Postal Code: | 762486860 |
| Phone Number: | 8663892727 |
| Fax Number: | |
| NPI Enumeration Date: | 10/20/2009 |
| NPI Last Update Date: | 07/01/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | RN233973 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |