Individual
HEATHER L PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
100 GRAND ST, NEW BRITAIN, CT 06052-2016
(860) 224-5011
Mailing address
11781 LEE JACKSON MEMORIAL HWY, STE 550, FAIRFAX, VA 22033-3309
(571) 777-5164
(703) 890-2650
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
092714
CT
367500000X
Certified Registered Nurse Anesthetist
Primary
004328
CT
367500000X
Certified Registered Nurse Anesthetist
181281
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
41650
AANA
—
Enumeration date
06/20/2006
Last updated
09/04/2015
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