Provider Demographics
NPI:1710497748
Name:PHILLIPS, EMILY ANNE (ACNP)
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:ANNE
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:PO BOX 1510
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47706-1510
Mailing Address - Country:US
Mailing Address - Phone:812-450-6815
Mailing Address - Fax:812-450-6822
Practice Address - Street 1:421 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47713-1227
Practice Address - Country:US
Practice Address - Phone:812-426-6638
Practice Address - Fax:812-450-8109
Is Sole Proprietor?:No
Enumeration Date:2017-10-04
Last Update Date:2018-03-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN71007735A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner