Individual
CALEB PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(678) 209-2394
Mailing address
1220 KIRKLAND RD, COVINGTON, GA 30016-2938
(706) 581-1799
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
RN293596
GA
Other
Enumeration date
08/17/2020
Last updated
08/17/2020
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