Provider Demographics
NPI:1710443221
Name:PHILLIPS-DUNCAN, PAULA RUTH (RN, BSN, CBN)
Entity Type:Individual
Prefix:MS
First Name:PAULA
Middle Name:RUTH
Last Name:PHILLIPS-DUNCAN
Suffix:
Gender:F
Credentials:RN, BSN, CBN
Other - Prefix:MS
Other - First Name:PAULA
Other - Middle Name:RUTH
Other - Last Name:PHILLIPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1200 NORTHSIDE FORSYTH DR
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-7659
Mailing Address - Country:US
Mailing Address - Phone:770-292-4726
Mailing Address - Fax:770-292-4727
Practice Address - Street 1:1200 NORTHSIDE FORSYTH DR
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-7659
Practice Address - Country:US
Practice Address - Phone:770-292-4726
Practice Address - Fax:770-292-4727
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-20
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN123801163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse