Healthcare Provider Details

I. General information

NPI: 1720545718
Provider Name (Legal Business Name): CHRISTI PHILLIP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2019
Last Update Date: 02/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

967 HEREFORD DR
AKRON OH
44303-1203
US

IV. Provider business mailing address

967 HEREFORD DR
AKRON OH
44303-1203
US

V. Phone/Fax

Practice location:
  • Phone: 330-256-0087
  • Fax:
Mailing address:
  • Phone: 330-256-0087
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN.433352
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: