Provider Demographics
NPI:1821192261
Name:PHILLIPS, LOIS ANN (RN)
Entity Type:Individual
Prefix:MRS
First Name:LOIS
Middle Name:ANN
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8852 HIDDENSPRING WAY
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-6153
Mailing Address - Country:US
Mailing Address - Phone:916-684-5042
Mailing Address - Fax:
Practice Address - Street 1:601 N MARKET BLVD
Practice Address - Street 2:SUITE 350
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-1200
Practice Address - Country:US
Practice Address - Phone:916-922-2771
Practice Address - Fax:916-922-8608
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA143924163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult