Provider Demographics
NPI:1497783799
Name:PHILLIPS, CLAUDIA (FNP)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 LONG PLAIN RD
Mailing Address - Street 2:
Mailing Address - City:LEVERETT
Mailing Address - State:MA
Mailing Address - Zip Code:01054-9523
Mailing Address - Country:US
Mailing Address - Phone:413-548-9283
Mailing Address - Fax:
Practice Address - Street 1:MERCY MEDICAL CENTER
Practice Address - Street 2:271 CAREW ST
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01102
Practice Address - Country:US
Practice Address - Phone:413-748-9064
Practice Address - Fax:413-748-9049
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA169506363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily