Individual
SAMANTHA GRACE PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 962-2848
(317) 962-3916
Mailing address
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 962-2848
(317) 962-3916
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28288178A
IN
363LA2100X
Acute Care Nurse Practitioner
Primary
71015440A
IN
363LG0600X
Gerontology Nurse Practitioner
71015440A
IN
Other
Enumeration date
08/14/2024
Last updated
02/14/2025
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