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Individual
MINU PHILIPOSE
Active
Individual
MINU PHILIPOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
18276
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103G709374
MEDICARE PTAN
TN
01
—
6009693
BCBS OF TENNESSEE
TN
05
—
Q006700
—
TN
Enumeration date
01/17/2014
Last updated
03/30/2016
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