Healthcare Provider Details

I. General information

NPI: 1053505768
Provider Name (Legal Business Name): CHINA HENRY PHILLIPS APRN, BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2007
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7020 MOON ROAD
COLUMBUS GA
31909
US

IV. Provider business mailing address

7020 MOON RD
COLUMBUS GA
31909-4900
US

V. Phone/Fax

Practice location:
  • Phone: 706-569-7992
  • Fax: 706-569-8560
Mailing address:
  • Phone: 706-569-7992
  • Fax: 706-569-8560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-NP141185
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: