MEDICARE: MS. JULIA MAY PHILLIPS APRN

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	101YM0800X	Mental Health Counselor	APRN-819	HI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	25221	OTHER	HI	HMSA PROVIDER #

General Provider Information

NPI Number	:	1629119870
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JULIA MAY PHILLIPS APRN

Provider Business Mailing Address
First Line	:	3254 PATY DR.HONOLULU,HI
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96822
Country	:	US
Telephone Number	:	808-988-1219
Fax Number	:	808-947-5978

Provider Business Practice Location Address
First Line	:	1500 S BERETANIA ST
Second Line	:	SUITE 105
City	:	HONOLULU
State	:	HI
Zip	:	96826-1932
Country	:	US
Telephone Number	:	808-946-4814
Fax Number	:	808-947-5978

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

Provider Enumeration Date	:	02/09/2007
Last Update Date	:	07/08/2007

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