Individual
MISS STACEY ANN MARIE PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
40700 CALIFORNIA OAKS RD, SUITE 202, MURRIETA, CA 92562-5795
(951) 894-5072
(951) 894-7324
Mailing address
40700 CALIFORNIA OAKS RD, SUITE 202, MURRIETA, CA 92562
(951) 894-5072
(951) 894-7324
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
263312
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
330652055
—
CA
Enumeration date
07/08/2013
Last updated
07/08/2013
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