Provider Demographics
NPI:1871218248
Name:PHILIP, CATHLEEN MARY (RN)
Entity type:Individual
Prefix:MRS
First Name:CATHLEEN
Middle Name:MARY
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 1:2237 N HULLEN ST STE 203
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-6913
Mailing Address - Country:US
Mailing Address - Phone:504-491-2335
Mailing Address - Fax:504-324-0173
Practice Address - Street 1:2237 N HULLEN ST STE 203
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-6913
Practice Address - Country:US
Practice Address - Phone:504-491-2335
Practice Address - Fax:504-324-0173
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-07
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN100259163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool