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NPI Code Detail

MEDICARE: DR. NICOLE ANN PHILLIPS PHARMD, RPH

MEDICARE: DR. NICOLE ANN PHILLIPS PHARMD, RPH
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
11835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistI026092AZ

General Provider Information

NPI Number : 1649971227
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NICOLE ANN PHILLIPS PHARMD, RPH
Provider Business Mailing Address
First Line : 2005 N 103RD AVE UNIT 12201
Second Line :
City : AVONDALE
State : AZ
Zip : 85392-4568
Country : US
Telephone Number : 360-929-4455
Fax Number :
Provider Business Practice Location Address
First Line : 8325 W INDIAN SCHOOL RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85037-2125
Country : US
Telephone Number : 623-245-7353
Fax Number : 623-245-7347
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/13/2023
Last Update Date : 06/15/2026

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