Individual
MRS. JENNIFER PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.N.
Contact information
Practice address
802 KAUFMAN AVE, TAHLEQUAH, OK 74464-5145
(918) 456-9524
Mailing address
802 KAUFMAN AVE, TAHLEQUAH, OK 74464-5145
(918) 456-9524
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
R0028259
OK
Other
Enumeration date
04/19/2007
Last updated
07/08/2007
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