Individual
DANIEL J PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2080 W ARLINGTON BLVD STE B, GREENVILLE, NC 27834-3770
(527) 522-1402
(252) 689-6502
Mailing address
2080 W ARLINGTON BLVD STE B, GREENVILLE, NC 27834-3770
(527) 522-1402
(252) 689-6502
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
185316
NC
367500000X
Certified Registered Nurse Anesthetist
075314
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
417
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201442673
TRICARE
NC
05
—
8052847
—
NC
01
—
P0601416
RAILROAD MEDICARE
NC
Enumeration date
01/11/2007
Last updated
05/04/2021
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