Individual
SUSAN K PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4001 WABASH AVE, TERRE HAUTE, IN 47803-1678
(812) 238-7788
(812) 238-4508
Mailing address
4001 WABASH AVE, TERRE HAUTE, IN 47803-1678
(812) 238-7788
(812) 238-4508
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71001696
IN
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
28112100A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200520070
—
IN
01
—
P00431348
RR MEDICARE
IN
Enumeration date
11/03/2005
Last updated
02/24/2016
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