Provider Demographics
NPI:1356859656
Name:PHILLIPS, SHEILA ANN (LPN)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:ANN
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3044 ENGLISH COLONY DR
Mailing Address - Street 2:
Mailing Address - City:LA PLACE
Mailing Address - State:LA
Mailing Address - Zip Code:70068-2229
Mailing Address - Country:US
Mailing Address - Phone:504-265-2645
Mailing Address - Fax:
Practice Address - Street 1:3044 ENGLISH COLONY DR
Practice Address - Street 2:
Practice Address - City:LA PLACE
Practice Address - State:LA
Practice Address - Zip Code:70068-2229
Practice Address - Country:US
Practice Address - Phone:504-265-2645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-21
Last Update Date:2018-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA270541164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty