Individual
AUDREY ANNE PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LBSW RN
Contact information
Practice address
375 APPLE TREE DR, IONIA, MI 48846-7506
(616) 527-1790
(616) 527-0538
Mailing address
10685 VELMA DR, GREENVILLE, MI 48838-9120
(616) 225-2365
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
6802080626
MI
163W00000X
Registered Nurse
Primary
4704314040
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1715928
—
MI
Enumeration date
09/29/2006
Last updated
08/13/2015
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