MEDICARE: NANCY F PHILLIPS NP

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	210547	MA

General Provider Information

NPI Number	:	1780640771
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY F PHILLIPS NP

Provider Business Mailing Address
First Line	:	1 HOSPITAL ROAD
Second Line	:
City	:	OAK BLUFFS
State	:	MA
Zip	:	02557-1477
Country	:	US
Telephone Number	:	508-693-3164
Fax Number	:	508-696-5238

Provider Business Practice Location Address
First Line	:	ONE HOSPITAL ROAD
Second Line	:
City	:	OAK BLUFFS
State	:	MA
Zip	:	02557-1477
Country	:	US
Telephone Number	:	508-693-3164
Fax Number	:	508-696-5238

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

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	05/13/2016

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