Provider Demographics
NPI:1669007282
Name:PHILLIPS, MARIA L (NP)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:L
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:2000 HEALTH PARK DR FL HP2
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4692
Mailing Address - Country:US
Mailing Address - Phone:615-373-7600
Mailing Address - Fax:
Practice Address - Street 1:1802 ELECTRIC RD
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-1619
Practice Address - Country:US
Practice Address - Phone:540-283-3760
Practice Address - Fax:540-989-2869
Is Sole Proprietor?:No
Enumeration Date:2020-03-04
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0024178965363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner