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NPI Code Detail

MEDICARE: KRISTIANA ROSE PHILLIPS

MEDICARE: KRISTIANA ROSE PHILLIPS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1222Q00000XDevelopmental Therapist

General Provider Information

NPI Number : 1952245409
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTIANA ROSE PHILLIPS
Provider Business Mailing Address
First Line : 256 N OLD STATE ROAD 67 S
Second Line :
City : MARTINSVILLE
State : IN
Zip : 46151-6244
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1200 E 42ND ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46205-2004
Country : US
Telephone Number : 317-550-4800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2026
Last Update Date : 04/15/2026

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Directions to “ KRISTIANA ROSE PHILLIPS ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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