Provider Demographics
NPI:1225627748
Name:PHIPPS, EULALA SAMANTHA (FNP-C)
Entity Type:Individual
Prefix:
First Name:EULALA
Middle Name:SAMANTHA
Last Name:PHIPPS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:291 S DAISY ST
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37813-2362
Mailing Address - Country:US
Mailing Address - Phone:423-616-8315
Mailing Address - Fax:423-616-8316
Practice Address - Street 1:291 S DAISY ST
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37813-2362
Practice Address - Country:US
Practice Address - Phone:423-616-8315
Practice Address - Fax:423-616-8316
Is Sole Proprietor?:No
Enumeration Date:2021-01-11
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024180735363LF0000X
TN28953363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily