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General NPI Number Information
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NPI Number | 1346890241
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Entity Type | Individual
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Provider Name | BOBBI AMBER PHILLIPS
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Gender | Female
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Dates
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Enumeration Date | 09/13/2019
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Last Update Date | 09/13/2019
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Provider Practice Location Address
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Address Line | 215 E 13TH AVE
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City | CORDELE
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State | GA
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Zip | 31015-4249
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Country | US
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Telephone | 229-276-0100
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Fax | 229-276-0300
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Provider Business Mailing Address
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Address Line | 127 EISENHOWER RD
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City | REBECCA
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State | GA
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Zip | 31783-3323
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Country | US
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Telephone | 229-325-5132
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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 | RN227968
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License Number State | GA
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