Healthcare Provider Details

I. General information

NPI: 1760071997
Provider Name (Legal Business Name): AMANDA BROOKE PHILLIPS MA-MCHS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2021
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5511 W 56TH AVE
ARVADA CO
80002-2807
US

IV. Provider business mailing address

5511 W 56TH AVE
ARVADA CO
80002-2807
US

V. Phone/Fax

Practice location:
  • Phone: 303-828-7473
  • Fax:
Mailing address:
  • Phone: 303-828-7473
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: