MEDICARE: LAUREN JEANNE PHILLIPS CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	APRRNCNP10157	OH

General Provider Information

NPI Number	:	1598900516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN JEANNE PHILLIPS CNP

Provider Business Mailing Address
First Line	:	2100 W CENTRAL AVE STE 100
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43606-3817
Country	:	US
Telephone Number	:	419-537-5111
Fax Number	:	419-537-5131

Provider Business Practice Location Address
First Line	:	2100 W CENTRAL AVE STE 100
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43606-3817
Country	:	US
Telephone Number	:	419-537-5111
Fax Number	:	419-537-5131

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/04/2008
Last Update Date	:	11/03/2023

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