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General NPI Number Information
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NPI Number | 1003792011
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Entity Type | Individual
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Provider Name | LEANNA MICHELLE PHILLIPS NP
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Gender | Female
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Dates
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Enumeration Date | 08/14/2025
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 3400 HIGHWAY 78 E STE 321
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City | JASPER
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State | AL
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Zip | 35501-8951
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Country | US
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Telephone | 205-226-5900
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Fax |
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Provider Business Mailing Address
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Address Line | 9991 BANKSTON RD
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City | DORA
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State | AL
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Zip | 35062-1724
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Country | US
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Telephone | 205-639-4883
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1-137809
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License Number State | AL
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