Individual
JEAN L PHILLPOTTS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
4015 DAVISON RD, BURTON, MI 48509-1401
(810) 715-1875
(810) 742-8911
Mailing address
401 S BALLENGER HWY, FLINT, MI 48532-3638
(810) 342-1000
(810) 342-1590
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
4704114147
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1010141
HEALTH ADVANTAGE NETWORK
MI
01
—
4208702600
BLUE CROSS BLUE SHIELD
MI
05
—
4622798
—
MI
05
—
4622831
—
MI
Enumeration date
12/13/2005
Last updated
07/08/2007
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