Individual
MRS. JESSICA LAURA PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1081 FENTON PARK DR, FENTON, MO 63026-7614
(573) 883-6434
Mailing address
1081 FENTON PARK DR, FENTON, MO 63026-7614
(573) 883-6434
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2021006345
MO
363LF0000X
Family Nurse Practitioner
209023707
IL
Other
Enumeration date
08/25/2021
Last updated
08/25/2021
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