Individual
BRIAN RUSSELL PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
9250 COLUMBIA AVE STE 2E, MUNSTER, IN 46321-3530
(219) 648-2400
Mailing address
9250 COLUMBIA AVE STE 2E, MUNSTER, IN 46321-3530
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71013428A
IN
Other
Enumeration date
01/06/2023
Last updated
11/07/2023
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