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NPI Code Detail

MEDICARE: SIERRA PHILLIPS

MEDICARE: SIERRA PHILLIPS
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
1106S00000XBehavior TechnicianTN

General Provider Information

NPI Number : 1932970365
Entity Type Code : Individual
Provider Name (Legal Business Name) : SIERRA PHILLIPS
Provider Business Mailing Address
First Line : 512 OLD HICKORY BLVD APT 1420
Second Line :
City : NASHVILLE
State : TN
Zip : 37209-5195
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3808 PARK AVE
Second Line :
City : NASHVILLE
State : TN
Zip : 37209-3741
Country : US
Telephone Number : 615-331-1141
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/15/2024
Last Update Date : 01/15/2024

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Directions to “ SIERRA PHILLIPS ” Practice Location

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