Individual
MS. BRENDA LEE PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP PMHNP-BC, FNP-BC
Contact information
Practice address
1451 N LAKELAND DR, MERIDIAN, MS 39307-9020
(601) 581-8526
Mailing address
PO BOX 4128, MERIDIAN, MS 39304-4128
(601) 581-8526
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
R852932
MS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R852932
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08689796
—
MS
Enumeration date
05/07/2012
Last updated
01/23/2020
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