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General NPI Number Information
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NPI Number | 1689184491
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Entity Type | Individual
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Provider Name | VALARIE PHILLIPS CCM
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Gender | Female
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Dates
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Enumeration Date | 10/06/2017
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Last Update Date | 10/06/2017
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Provider Practice Location Address
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Address Line | 292 PICKENS CIR
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City | CARTHAGE
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State | MS
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Zip | 39051-7982
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Country | US
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Telephone | 760-270-3791
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Fax |
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Provider Business Mailing Address
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Address Line | 15911 SANDALWOOD CREEK DR
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City | WILDWOOD
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State | MO
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Zip | 63011-5518
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Country | US
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Telephone | 760-270-3791
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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 | 163WA2000X
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Taxonomy Name | Administrator Registered Nurse
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License Number | 29383
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | 609662
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 163WC1600X
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Taxonomy Name | Continuing Education/Staff Development Registered Nurse
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License Number | 609662
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 609662
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 163WP2201X
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Taxonomy Name | Ambulatory Care Registered Nurse
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License Number | 609662
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License Number State | CA
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Taxonomy #6
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 347E00000X
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Taxonomy Name | Transportation Broker
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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