Individual
LAURA POLK PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
125 STONE CREEK DR, MADISON, MS 39110-5058
(662) 207-3135
Mailing address
125 STONE CREEK DR, MADISON, MS 39110-5058
(662) 207-3135
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
127477
MS
Other
Enumeration date
05/14/2020
Last updated
05/14/2020
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