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General NPI Number Information
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NPI Number | 1699668491
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Entity Type | Individual
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Provider Name | KAMMI L PHILLIPS
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Gender | Female
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Dates
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Enumeration Date | 05/30/2025
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 53585 NOKOMIS RD
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City | ASHLAND
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State | WI
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Zip | 54806-4272
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Country | US
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Telephone | 715-685-7887
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Fax |
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Provider Business Mailing Address
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Address Line | 1405 ARROW POINT DR STE 1106
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City | CEDAR PARK
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State | TX
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Zip | 78613-0185
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Country | US
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Telephone | 210-531-1206
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Fax | 561-612-2096
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | H-0009266-C
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License Number State | AL
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