Individual
TAYLOR BRE-AN PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 N MAIN ST, ANNA, IL 62906-1652
(618) 833-2118
Mailing address
8265 HIGHWAY 13 W, CARRIER MILLS, IL 62917-2016
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043.124737
IL
Other
Enumeration date
11/12/2017
Last updated
11/12/2017
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