Individual
MR. TIMOTHY JAMES PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
7160 RAFAEL RIVERA WAY STE 210, LAS VEGAS, NV 89113-5395
(702) 878-0070
(702) 805-0307
Mailing address
PO BOX 840857, DALLAS, TX 75284-0857
(702) 878-0070
(702) 805-0307
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
862407
NV
367500000X
Certified Registered Nurse Anesthetist
9177869
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
303719300
—
FL
Enumeration date
07/21/2006
Last updated
10/20/2023
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