Provider Demographics
NPI:1013009026
Name:PHILLIPS, VALERIE JOY (CNM)
Entity Type:Individual
Prefix:MS
First Name:VALERIE
Middle Name:JOY
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76010-7329
Mailing Address - Country:US
Mailing Address - Phone:817-456-8919
Mailing Address - Fax:817-542-0024
Practice Address - Street 1:3453 SAINT FRANCIS AVE
Practice Address - Street 2:SUITE 128
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75228-7199
Practice Address - Country:US
Practice Address - Phone:972-279-0559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX558109367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife