Individual
JANNA PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
713 LOMAX AVE, WAYNESBORO, MS 39367-2556
(601) 671-2400
Mailing address
117 S 11TH AVE, PO BOX 4361, LAUREL, MS 39440-4312
(601) 425-3033
(601) 422-0431
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R896723
MS
363LF0000X
Family Nurse Practitioner
RN133630
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003125577A
—
GA
05
—
00479267
—
MS
Enumeration date
08/18/2011
Last updated
11/02/2017
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