Healthcare Provider Details

I. General information

NPI: 1285921908
Provider Name (Legal Business Name): LATOYA L PHILLIPS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2011
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3239 JEFFERSON AVE STE 1
CINCINNATI OH
45220-2270
US

IV. Provider business mailing address

3239 JEFFERSON AVE STE 1
CINCINNATI OH
45220-2270
US

V. Phone/Fax

Practice location:
  • Phone: 513-400-4976
  • Fax: 513-214-0400
Mailing address:
  • Phone: 513-400-4976
  • Fax: 513-214-0400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number.CNP.0040259
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: