Provider Demographics
NPI:1790475986
Name:PHILLIPS, DANA ROSA (APRN, MSN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:ROSA
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:APRN, MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FRANCESTOWN
Mailing Address - State:NH
Mailing Address - Zip Code:03043-3026
Mailing Address - Country:US
Mailing Address - Phone:603-703-8908
Mailing Address - Fax:
Practice Address - Street 1:29 RIVERSIDE ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03062-1396
Practice Address - Country:US
Practice Address - Phone:603-880-4150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-10
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH074861-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily