Healthcare Provider Details

I. General information

NPI: 1558220111
Provider Name (Legal Business Name): NATALIE PHILLIPS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 W AYLESBURY RD STE 600
TIMONIUM MD
21093-4168
US

IV. Provider business mailing address

15 W AYLESBURY RD STE 600
TIMONIUM MD
21093-4168
US

V. Phone/Fax

Practice location:
  • Phone: 410-575-1200
  • Fax:
Mailing address:
  • Phone: 410-575-1200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: