Healthcare Provider Details

I. General information

NPI: 1558877423
Provider Name (Legal Business Name): ALISON QUINN PHILLIPS N.P. PMH-NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2017
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 SAINT PAUL ST STE 820
BALTIMORE MD
21202-1681
US

IV. Provider business mailing address

55 HATCHETTS HILL RD
OLD LYME CT
06371-1534
US

V. Phone/Fax

Practice location:
  • Phone: 800-370-3651
  • Fax: 877-515-7147
Mailing address:
  • Phone: 800-370-3651
  • Fax: 877-515-7147

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN1029247
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN1029247
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: