Provider Demographics
NPI:1346075694
Name:PHELPS, CATHERINE CECILIA (MSN, APRN, WHNP-BC)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:CECILIA
Last Name:PHELPS
Suffix:
Gender:F
Credentials:MSN, APRN, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9331 MEADOWKNOLL DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-6109
Mailing Address - Country:US
Mailing Address - Phone:832-247-2604
Mailing Address - Fax:
Practice Address - Street 1:712 N WASHINGTON AVE STE 250
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1631
Practice Address - Country:US
Practice Address - Phone:214-515-9001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1173749363LW0102X, 363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology