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Individual
KATHARINE MCCHESNEY PHILLIPS
Active
Individual
KATHARINE MCCHESNEY PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1300
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1192PA
—
SC
05
—
FQC088
—
SC
Enumeration date
05/14/2008
Last updated
06/11/2012
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