Provider Demographics
NPI:1558055954
Name:PIPKINS, MYRNA
Entity Type:Individual
Prefix:
First Name:MYRNA
Middle Name:
Last Name:PIPKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MYRNA
Other - Middle Name:
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:15626 MOUNTAIN MIST TRL
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77049-5612
Mailing Address - Country:US
Mailing Address - Phone:713-894-8717
Mailing Address - Fax:
Practice Address - Street 1:15626 MOUNTAIN MIST TRL
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77049-5612
Practice Address - Country:US
Practice Address - Phone:713-894-8717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-07
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty
No374K00000XNursing Service Related ProvidersReligious Nonmedical PractitionerGroup - Single Specialty
No374T00000XNursing Service Related ProvidersReligious Nonmedical Nursing PersonnelGroup - Single Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty