# STACY PHILLIPS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1235446972
- **Gender:** F
- **Credential:** RN

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WG0000X | General Practice Registered Nurse | 075385 | CT | — |
| 363LA2100X | Acute Care Nurse Practitioner | 004501 | CT | Yes |

## Other

- **Enumeration date:** 09/01/2010
- **Last updated:** 09/12/2022