Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LN0000X | Nurse Practitioner - Neonatal | 685965 | TX |
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 685365 | TX |
N | 363LP2300X | Nurse Practitioner - Primary Care | 685965 | TX |
NPI | 1164563813 |
---|---|
Provider Name | Ms. Constance Elaine Cephus |
First Address | Spring, TX 77379-4052 |
Second Address | Houston, TX 77030-2303 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2007 |
Last Update Date | 15/07/2010 |