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Organization
JAN D. PHELPS, PA
Active
Organization
JAN D. PHELPS, PA
Active
Other names
Abbey Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JAN DENICE PHELPS ARNPC (OWNER)
(813) 931-9094
Entity
Organization
Contact information
Practice address
1442 W BUSCH BLVD, TAMPA, FL 33612-7602
(813) 931-9094
(813) 935-1126
Mailing address
1442 W BUSCH BLVD, TAMPA, FL 33612-7602
(813) 931-9094
(813) 935-1126
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1851392
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1851392
LICENSE
FL
05
—
305568000
—
FL
01
—
P62395
UPIN
FL
01
—
Y031B
BCBS
FL
Enumeration date
10/22/2007
Last updated
05/17/2011
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