Provider Demographics
NPI:1871069237
Name:JUBRIL, ERONMWON MODUPE (RN,BSN, MSN, FNP-C)
Entity type:Individual
Prefix:
First Name:ERONMWON
Middle Name:MODUPE
Last Name:JUBRIL
Suffix:
Gender:F
Credentials:RN,BSN, MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1203 WHISPERING WILLOW CT
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-4013
Mailing Address - Country:US
Mailing Address - Phone:832-274-6977
Mailing Address - Fax:
Practice Address - Street 1:1203 WHISPERING WILLOW CT
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-4013
Practice Address - Country:US
Practice Address - Phone:832-274-6977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-23
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP131892363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily