Provider Demographics
NPI:1760668206
Name:PHILLIPS, LEANN KATHERINE (PHN RN)
Entity Type:Individual
Prefix:MRS
First Name:LEANN
Middle Name:KATHERINE
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:PHN RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 E VALLEY PKWY
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-3008
Mailing Address - Country:US
Mailing Address - Phone:760-740-4098
Mailing Address - Fax:
Practice Address - Street 1:606 E VALLEY PKWY
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-3008
Practice Address - Country:US
Practice Address - Phone:760-740-4098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-15
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA301692163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management