Provider Demographics
NPI:1093777450
Name:PHIPPS, JUDY KAREN (RN, FNP-C)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:KAREN
Last Name:PHIPPS
Suffix:
Gender:F
Credentials:RN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 CEDAR TRAILS DR
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:TX
Mailing Address - Zip Code:76513-6507
Mailing Address - Country:US
Mailing Address - Phone:254-780-9891
Mailing Address - Fax:254-780-9869
Practice Address - Street 1:65 CEDAR TRAILS DR
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:TX
Practice Address - Zip Code:76513-6507
Practice Address - Country:US
Practice Address - Phone:254-780-9891
Practice Address - Fax:254-780-9869
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-03
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX243833363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX92913503Medicaid
TXP00255181OtherRAILROAD
TX8N8661OtherBCBS
TXS41868Medicare UPIN
TX92913503Medicaid