Healthcare Provider Details

I. General information

NPI: 1770435927
Provider Name (Legal Business Name): MRS. CHRISTINE ADELE PHILLIPS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/11/2026
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7520 LAUDEN DR
LAKE WORTH FL
33467-7802
US

IV. Provider business mailing address

7520 LAUDEN DR
LAKE WORTH FL
33467-7802
US

V. Phone/Fax

Practice location:
  • Phone: 561-271-5572
  • Fax: 561-271-5572
Mailing address:
  • Phone: 561-271-5572
  • Fax: 561-271-5572

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN9259547
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: