Provider Demographics
NPI:1780640771
Name:PHILLIPS, NANCY F (NP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:F
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HOSPITAL ROAD
Mailing Address - Street 2:
Mailing Address - City:OAK BLUFFS
Mailing Address - State:MA
Mailing Address - Zip Code:02557-1477
Mailing Address - Country:US
Mailing Address - Phone:508-693-3164
Mailing Address - Fax:508-696-5238
Practice Address - Street 1:ONE HOSPITAL ROAD
Practice Address - Street 2:
Practice Address - City:OAK BLUFFS
Practice Address - State:MA
Practice Address - Zip Code:02557-1477
Practice Address - Country:US
Practice Address - Phone:508-693-3164
Practice Address - Fax:508-696-5238
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2016-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA210547363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner