Agbeyomi, Modupe
Agbeyomi, Modupe is an sole proprietor health care provider with primary practice located at 13 Corporate Blvd Ne Ste 200 , Brookhaven GA 30329-1900. She recently has 6 registered licenses in different health care specialties including Agencies / Home Infusion, Ambulatory Health Care Facilities / Infusion Therapy, Ambulatory Health Care Facilities / Migrant Health, Physician Assistants & Advanced Practice Nursing Providers / Primary Care, Physician Assistants & Advanced Practice Nursing Providers / School, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Agbeyomi, Modupe can be contacted via phone (770) 557-1079.Contact Information
Primary practice address
13 Corporate Blvd Ne Ste 200
Brookhaven GA 30329-1900
Phone: (770) 557-1079
Fax: (770) 872-6621
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Agencies / Home Infusion | 251F00000X | ||
| Ambulatory Health Care Facilities / Infusion Therapy | 261QI0500X | ||
| Ambulatory Health Care Facilities / Migrant Health | 261QM1000X | ||
| Physician Assistants & Advanced Practice Nursing Providers / Primary Care | 363LP2300X | F09180151 | Georgia |
| Physician Assistants & Advanced Practice Nursing Providers / School | 363LS0200X | F09180151 | Georgia |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | F09180151 | Georgia |
Profile Details
| NPI number | 1245715903 |
|---|---|
| LBN Legal business name | Agbeyomi, Modupe |
| Credentials | DNP, FNP-C |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 28th, 2018 |
| Last updated | Nov 29th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245715903 | NPPES |
| Georgia | MEDICAID | F09180151 |
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