Individual
MS. REGINA D PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1011 EAGLES RIDGE CT, LAWRENCEVILLE, GA 30043-4196
(513) 237-8089
Mailing address
1011 EAGLES RIDGE CT, LAWRENCEVILLE, GA 30043-2825
(513) 237-8098
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN232977
GA
1744P3200X
Prosthetics Case Management
431983029
GA
1744P3200X
Prosthetics Case Management
431983029
OH
343900000X
Non-emergency Medical Transport (VAN)
431983029
GA
347C00000X
Private Vehicle
431983029
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4319893029
—
GA
05
—
813745446
—
GA
Enumeration date
05/17/2015
Last updated
10/07/2016
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