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General NPI Number Information
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NPI Number | 1720068505
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Entity Type | Individual
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Provider Name | MS. PHYLLIS AUSTIN
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Gender | Female
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Dates
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Enumeration Date | 01/18/2006
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Last Update Date | 12/13/2016
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Provider Practice Location Address
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Address Line | 4863 N. NEVADA AVENUE
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918
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Country | US
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Telephone | 719-255-8001
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Fax |
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Provider Business Mailing Address
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Address Line | 4863 N. NEVADA AVENUE
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918
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Country | US
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Telephone | 719-255-4419
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RNX163309
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License Number State | CO
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