Individual
MRS. FANNIE LOUISE PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
13516 CLAIBORNE RD, EAST CLEVELAND, OH 44112-3154
(216) 681-2792
Mailing address
13516 CLAIBORNE RD, EAST CLEVELAND, OH 44112-3154
(216) 681-2792
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN083060
OH
Other
Enumeration date
12/13/2016
Last updated
12/13/2016
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