Provider Demographics
NPI:1679677660
Name:PHIPPS, BRANDY MICHELLE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:BRANDY
Middle Name:MICHELLE
Last Name:PHIPPS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:BRANDY
Other - Middle Name:MICHELLE
Other - Last Name:VOILES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:PO BOX 9054
Mailing Address - Street 2:
Mailing Address - City:GRAY
Mailing Address - State:TN
Mailing Address - Zip Code:37615-9054
Mailing Address - Country:US
Mailing Address - Phone:423-467-3600
Mailing Address - Fax:423-467-3696
Practice Address - Street 1:101 LENA DR
Practice Address - Street 2:
Practice Address - City:ROGERSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37857
Practice Address - Country:US
Practice Address - Phone:423-272-9239
Practice Address - Fax:423-272-1803
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPN60830164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse