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General NPI Number Information
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NPI Number | 1689289464
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Entity Type | Individual
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Provider Name | HEATHER PHILLIPS SILVERII FNP
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Gender | Female
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Dates
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Enumeration Date | 09/09/2020
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Last Update Date | 09/09/2020
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Provider Practice Location Address
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Address Line | 501 AVALON WAY STE C
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City | BRANDON
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State | MS
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Zip | 39047-7500
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Country | US
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Telephone | 601-992-9790
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Fax |
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Provider Business Mailing Address
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Address Line | 4701 LAKELAND DR APT 18B
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City | FLOWOOD
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State | MS
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Zip | 39232-9790
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Country | US
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Telephone | 601-757-6751
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 903199
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License Number State | MS
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