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General NPI Number Information
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NPI Number | 1073338950
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Entity Type | Individual
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Provider Name | KERSTIE PHILLS PA
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Gender | Female
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Dates
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Enumeration Date | 11/18/2024
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Last Update Date | 01/20/2026
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Provider Practice Location Address
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Address Line | 512 CYPRESS PKWY FL POLKC
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City | POINCIANA
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State | FL
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Zip | 34759-3310
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Country | US
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Telephone | 407-483-4950
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Fax | 407-442-3490
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Provider Business Mailing Address
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Address Line | 512 CYPRESS PKWY
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City | POINCIANA
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State | FL
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Zip | 34759-3310
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Country | US
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Telephone | 407-483-4950
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Fax | 407-442-3490
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9119870
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License Number State | FL
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