| Provider / Organization | NPI | Date Certified |
|---|---|---|
| MISTY RAE PHILLIPS | 1124678156 | 2022-01-16 |
Misty R Stauffer [F] graduated in 2019 and primarily specializes in Nurse Practitioner.
Misty Rae Phillips is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1124678156. Registration indicates Misty Rae Phillips is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Nurse Practitioner: Family, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner Family, Physician Assistants & Advanced Practice Nursing Providers) (Nurse Practitioner, ) Access to Adult/Geriatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Nurse Practitioner: Family, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner Family, Physician Assistants & Advanced Practice Nursing Providers) (Nurse Practitioner, )
| PECOS ID | 6406280270 |
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Misty Rae Phillips FNP |
| Other Provider Name | Misty Rae Stauffer |
| Practice Office Address | 282 SADIE FREEMAN DR LUFKIN, TX US |
| Practice Office Telephone | 9363155011 |
| Mailing Address | PO BOX 1032 HUNTINGTON, TX 759491032 US |
| Code | Practice | License No State |
|---|---|---|
| 363LF0000X | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse PractitionerAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Nurse Practitioner: Family All Other Specialties & Provider Types Nurse Practitioner Family Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | 897445
TX |
| 363LF0000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse PractitionerAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Nurse Practitioner: Family All Other Specialties & Provider Types Nurse Practitioner Family Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | F09190179
TX |
| F09190179 | OTHER | TX | AANP |
| 897445 | OTHER | TX | TX BON RN |