Provider Demographics
NPI:1164563813
Name:CEPHUS, CONSTANCE ELAINE (NNP, CPNP)
Entity Type:Individual
Prefix:MS
First Name:CONSTANCE
Middle Name:ELAINE
Last Name:CEPHUS
Suffix:
Gender:F
Credentials:NNP, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7727 LEAFBROOK LN
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-4052
Mailing Address - Country:US
Mailing Address - Phone:713-557-0783
Mailing Address - Fax:
Practice Address - Street 1:6621 FANNIN ST
Practice Address - Street 2:MC 1-9345-C
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2303
Practice Address - Country:US
Practice Address - Phone:832-826-5710
Practice Address - Fax:832-825-1107
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX685965363LN0000X, 363LP2300X
TX685365363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care