Individual
MRS. LAURA K PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
262089
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000065002
MEDICARE
MA
01
—
042297845
PHCS/MULTI-PLAN
—
05
—
110085470A
—
MA
01
—
1578694980
FALLON HEALTH CARE
—
01
—
SS0070
BCBSMA
MA
Enumeration date
03/08/2007
Last updated
02/17/2017
Update your record
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