Individual
DR. NISSY PHILIP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2301 HOLMES ST, KANSAS CITY, MO 64108-2640
(816) 404-4345
Mailing address
2301 HOLMES ST, KANSAS CITY, MO 64108-2640
(816) 404-4345
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2019038861
MO
390200000X
Student in an Organized Health Care Education/Training Program
2019022202
MO
Other
Enumeration date
01/04/2017
Last updated
06/25/2020
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