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NPI Code Detail

MEDICARE: MISS MICHELLE KAY PHILLIPS LPN

MEDICARE: MISS MICHELLE KAY PHILLIPS LPN
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
1164W00000XLicensed Practical Nurse27047636AIN
2164W00000XLicensed Practical NurseLPN.167942.MEDSOH

General Provider Information

NPI Number : 1972725513
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS MICHELLE KAY PHILLIPS LPN
Provider Business Mailing Address
First Line : 4600 MONTGOMERY RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45212-2697
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5850 RIDGE RD
Second Line :
City : PARMA
State : OH
Zip : 44129-3169
Country : US
Telephone Number : 833-510-4357
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2007
Last Update Date : 07/31/2023

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Directions to “ MISS MICHELLE KAY PHILLIPS LPN” Practice Location

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