Provider Demographics
NPI:1568659548
Name:PHILIPS, JANE P (RN, MS, OCN, CLT)
Entity Type:Individual
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First Name:JANE
Middle Name:P
Last Name:PHILIPS
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Gender:F
Credentials:RN, MS, OCN, CLT
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Mailing Address - Street 1:615 N MICHIGAN ST
Mailing Address - Street 2:REHABILITATION SERVICES
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46601-1033
Mailing Address - Country:US
Mailing Address - Phone:574-647-1068
Mailing Address - Fax:574-647-7074
Practice Address - Street 1:615 N MICHIGAN ST
Practice Address - Street 2:REHABILITATION SERVICES
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46601-1033
Practice Address - Country:US
Practice Address - Phone:574-647-1068
Practice Address - Fax:574-647-7074
Is Sole Proprietor?:No
Enumeration Date:2007-10-03
Last Update Date:2007-10-03
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Provider Licenses
StateLicense IDTaxonomies
IN050864364SX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SX0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistOncology