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Individual
SHANTI SHIBU PHILIP
Active
Individual
SHANTI SHIBU PHILIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP126354
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0354351401
—
TX
Enumeration date
06/16/2015
Last updated
04/26/2016
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