Provider Demographics
NPI:1053644864
Name:PHILLIPS, CHRISTINA J (MSN-FNP)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:J
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:MSN-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 307
Mailing Address - Street 2:
Mailing Address - City:STILWELL
Mailing Address - State:KS
Mailing Address - Zip Code:66085-0307
Mailing Address - Country:US
Mailing Address - Phone:913-522-4894
Mailing Address - Fax:713-344-9420
Practice Address - Street 1:3901 RAINBOW BLVD
Practice Address - Street 2:2032 SON-MAIL STOP 4043
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66103-2937
Practice Address - Country:US
Practice Address - Phone:913-522-4894
Practice Address - Fax:713-344-9420
Is Sole Proprietor?:No
Enumeration Date:2009-09-11
Last Update Date:2009-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS46305363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily