Provider Demographics
NPI:1710537147
Name:PHILIPS, ALLISON K (BSN, MPH)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:K
Last Name:PHILIPS
Suffix:
Gender:F
Credentials:BSN, MPH
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:K
Other - Last Name:KILBURG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4262 GEMINI PATH
Mailing Address - Street 2:
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13090-1937
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:97 PATRICIA DR
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13212-4272
Practice Address - Country:US
Practice Address - Phone:315-409-3949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-17
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY662872163WX0200X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WX0200XNursing Service ProvidersRegistered NurseOncology