Healthcare Provider Details

I. General information

NPI: 1881035178
Provider Name (Legal Business Name): HANNAH ELIZABETH PHILLIPS PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2013
Last Update Date: 01/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 WESTHALL LN STE 207
MAITLAND FL
32751
US

IV. Provider business mailing address

2700 WESTHALL LN STE 207
MAITLAND FL
32751-7478
US

V. Phone/Fax

Practice location:
  • Phone: 800-840-2528
  • Fax: 407-540-9552
Mailing address:
  • Phone: 800-840-2528
  • Fax: 407-540-9552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberARNP9311719
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: