Individual
KIP PHILLIPS JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1481
TN
363A00000X
Physician Assistant
PA10699
TX
363AM0700X
Medical Physician Assistant
Primary
0010-03163
NC
Other
Enumeration date
02/27/2007
Last updated
09/18/2023
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