Provider Demographics
NPI:1952105983
Name:PHILIP, PRINCY (RN)
Entity type:Individual
Prefix:
First Name:PRINCY
Middle Name:
Last Name:PHILIP
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3426 PEBBLE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-1785
Mailing Address - Country:US
Mailing Address - Phone:845-659-4004
Mailing Address - Fax:
Practice Address - Street 1:3426 PEBBLE CREEK DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-1785
Practice Address - Country:US
Practice Address - Phone:845-659-4004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX913023163WM0102X, 163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WS0200XNursing Service ProvidersRegistered NurseSchoolGroup - Multi-Specialty
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn