Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 26NJ00784700 | NJ |
NPI | 1003394487 |
---|---|
Provider Name | Elizabeth Philip |
First Address | Flemington, NJ 08822-4600 |
Second Address | Flemington, NJ 08822-4600 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2018 |
Last Update Date | 23/11/2020 |