Individual
MS. JOAN SHELTON PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNPBC
Contact information
Practice address
13 MEDICAL CAMPUS DR NW STE 102, SUPPLY, NC 28462-4093
(910) 754-5988
(910) 754-5989
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5002927
NC
363LF0000X
Family Nurse Practitioner
0050-02927
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2592928
PTAN
—
05
—
7004010
—
NC
Enumeration date
03/20/2007
Last updated
03/02/2023
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