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Individual

SUSANNA CAROLINE PHILLIPS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
9981 S HEALTHPARK DR, FORT MYERS, FL 33908-3618
(239) 343-0284
(239) 343-0973
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-0284
(239) 343-0973

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
26J01070900
NJ
363LA2100X
Acute Care Nurse Practitioner
Primary
APRN9355406
FL
363LF0000X
Family Nurse Practitioner
26J01070900
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
023097600
FL
Enumeration date
11/22/2017
Last updated
04/10/2024
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