Healthcare Provider Details

I. General information

NPI: 1215355763
Provider Name (Legal Business Name): DEBORAH ANN PHLIPOT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS DEBORAH ANN SMITH

II. Dates (important events)

Enumeration Date: 04/02/2014
Last Update Date: 04/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

349 S. MAIN STREET COMMUNITY BLOOD CENTER/COMMUNITY TISSUE SERVICES
DAYTON OH
45402
US

IV. Provider business mailing address

349 S. MAIN STREET COMMUNITY BLOOD CENTER/COMMUNITY TISSUE SERVICES
DAYTON OH
45402
US

V. Phone/Fax

Practice location:
  • Phone: 937-461-3450
  • Fax: 937-461-9584
Mailing address:
  • Phone: 937-461-3450
  • Fax: 937-461-9584

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License NumberRN186320
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: