Individual
PHYLLIS NORENE MCIVER X
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1200 INTREPID AVE, PHILADELPHIA, PA 19112-1229
(717) 761-2633
Mailing address
18314 145TH ST E, BONNEY LAKE, WA 98391-6173
(253) 209-4402
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN00069996
WA
Other
Enumeration date
10/10/2022
Last updated
10/10/2022
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