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NPI Code Detail

MEDICARE: MRS. ELAINE T PHILIPSON RN, ACNP-BC

MEDICARE: MRS. ELAINE T PHILIPSON RN, ACNP-BC
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
1363LA2100XAcute Care Nurse Practitioner4704188649MI

General Provider Information

NPI Number : 1912237934
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ELAINE T PHILIPSON RN, ACNP-BC
Provider Business Mailing Address
First Line : 801 ROSEHILL RD
Second Line :
City : JACKSON
State : MI
Zip : 49202-1762
Country : US
Telephone Number : 517-539-5618
Fax Number : 517-212-2009
Provider Business Practice Location Address
First Line : 4760 FASHION SQUARE BLVD STE L-1
Second Line :
City : SAGINAW
State : MI
Zip : 48604-2620
Country : US
Telephone Number : 989-282-4003
Fax Number : 888-491-7220
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2010
Last Update Date : 03/15/2023

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