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Individual
JESSICA MARIE PHILLIPS
Active
Individual
JESSICA MARIE PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN146071
OH
172V00000X
Community Health Worker
146071
OH
251C00000X
Developmentally Disabled Services Day Training Agency
PN146071
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0077930
—
OH
Enumeration date
06/25/2012
Last updated
12/09/2015
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