Individual
MARIAH SHYANNE HALL PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
266 JOULE ST, ALCOA, TN 37701-2422
(865) 984-3864
(865) 380-4095
Mailing address
1275 DICK LONAS RD UNIT 101, KNOXVILLE, TN 37909-1383
(865) 584-4747
(865) 381-1509
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA0000004657
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q071442
—
TN
Enumeration date
06/17/2020
Last updated
07/22/2026
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