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General NPI Number Information
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NPI Number | 1902383862
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Entity Type | Individual
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Provider Name | CYNTHIA D PHILLIPS APRN
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Gender | Female
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Dates
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Enumeration Date | 07/24/2018
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Last Update Date | 12/03/2021
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Provider Practice Location Address
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Address Line | 2645 N LAUREL RD STE B
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City | LONDON
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State | KY
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Zip | 40741-9075
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Country | US
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Telephone | 513-834-7063
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Fax |
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Provider Business Mailing Address
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Address Line | 615 ELSINORE PL STE 200
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City | CINCINNATI
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State | OH
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Zip | 45202-1457
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Country | US
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Telephone | 513-834-7063
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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 | 3012365
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 3012365
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 3012365
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License Number State | KY
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