Provider Demographics
NPI:1669611414
Name:CUMBERBATCH, JOSEPHINE (NP)
Entity type:Individual
Prefix:MRS
First Name:JOSEPHINE
Middle Name:
Last Name:CUMBERBATCH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JOSEPHINE
Other - Middle Name:
Other - Last Name:MACKEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1504 TAUB LOOP
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1608
Mailing Address - Country:US
Mailing Address - Phone:713-873-3601
Mailing Address - Fax:713-873-6634
Practice Address - Street 1:301 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-5302
Practice Address - Country:US
Practice Address - Phone:409-266-1888
Practice Address - Fax:409-747-4947
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-17
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP125848363LW0102X, 364SW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SW0102XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistWomen's Health
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health