Individual
JOHN CALEB PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
UNIT MANAGER LPN
Contact information
Practice address
100 DAVCO DR, DANVILLE, KY 40422-8477
(859) 236-5383
(859) 270-7696
Mailing address
100 DAVCO DR, DANVILLE, KY 40422-8477
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2052375
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
364SL0600X
ASSISTED LIVING
KY
Enumeration date
06/11/2021
Last updated
07/12/2021
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