NPI | 1265420186 |
---|---|
Other Name | NICOLE PHILLIPS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA 193980) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA 193980) |
Enumeration Date | 2005-10-13 |
Last Update Date | 2021-08-06 |