Lillykutty Abraham Modoor NURSE PRACTITIONER

NPI # 

Practice Address:

650 Highland Ave Ste 100

Winston Salem, NC, 27101-4304

Practice Phone:

336-607-8523

Practice Fax:

336-773-0916

License Number:

5004280

License State:

NC

Taxonomy Grouping:

Physician Assistants & Advanced Practice Nursing Providers

Taxonomy Classification:

Nurse Practitioner

Taxonomy Code:

363L00000X

Updated by NPPES on 2/6/2023. You can view the original data set for NPI # 1013155969 on the official NPPES website. If the information about this NPI provider/company is outdated and you would like to help us update the information, you can Contact Us. This will only update NPI information on NPIScope.com. See our FAQ page for further information on updating NPI information.

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