Provider Demographics
NPI:1558612309
Name:PHILLIPS, EMILEE ERIN (MS, RD, LD)
Entity Type:Individual
Prefix:MRS
First Name:EMILEE
Middle Name:ERIN
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2408 HICKORYNUT CT
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-4568
Mailing Address - Country:US
Mailing Address - Phone:501-350-8116
Mailing Address - Fax:
Practice Address - Street 1:3401 W MARKHAM ST.
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205
Practice Address - Country:US
Practice Address - Phone:501-686-7390
Practice Address - Fax:501-296-1308
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1273282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital