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Individual

ALISHA LORRAINE PHILLIPS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
823 CENTER AVE, PAYETTE, ID 83661-2535
(208) 642-3396
(208) 642-9060
Mailing address
823 CENTER AVE, PAYETTE, ID 83661-2535
(208) 642-3396
(208) 642-9060

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
N-19189
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010147752
REGENCE BLUE SHIELD
05
278542
OR
05
806957500
ID
01
820525763
COMMERCIAL
01
NPPU5
BLUE CROSS
Enumeration date
01/30/2007
Last updated
06/14/2022
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