Individual
JACOB HUNTER PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGACNP-BC
Contact information
Practice address
95 JUDGE TANNER BLVD, COVINGTON, LA 70433-7500
(985) 867-3800
(985) 867-3644
Mailing address
PO BOX 3370, COVINGTON, LA 70434-3370
(985) 867-8585
(985) 867-3644
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
212776
LA
363LA2100X
Acute Care Nurse Practitioner
903925
MS
Other
Enumeration date
05/15/2020
Last updated
08/25/2022
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