Individual
MRS. CYNTHIA D PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2645 N LAUREL RD STE B, LONDON, KY 40741-9075
(513) 834-7063
Mailing address
615 ELSINORE PL STE 200, CINCINNATI, OH 45202-1457
(513) 834-7063
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
3012365
KY
363LG0600X
Gerontology Nurse Practitioner
3012365
KY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
3012365
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14299188
CAQH
KY
01
—
14299188
CAQH
—
Enumeration date
07/24/2018
Last updated
12/03/2021
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