Healthcare Provider Details

I. General information

NPI: 1659734820
Provider Name (Legal Business Name): DREW A PHILIP DNP, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2016
Last Update Date: 11/04/2024
Certification Date: 11/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UCI WEIGHT MANAGEMENT PROGRAM 19722 MACARTHUR BLVD
IRVINE CA
92612
US

IV. Provider business mailing address

PO BOX 1567
ROCKFORD IL
61110-0067
US

V. Phone/Fax

Practice location:
  • Phone: 949-824-8770
  • Fax:
Mailing address:
  • Phone: 779-696-7342
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95021305
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: