Individual
JESSICA ANNE PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3990 JOHN R ST, DETROIT, MI 48201-2018
(313) 745-8040
Mailing address
4517 SEYMOUR LAKE RD, OXFORD, MI 48371-4039
(517) 260-5630
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704295312
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
4704295312
MI
Other
Enumeration date
07/12/2018
Last updated
04/23/2019
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