Provider Demographics
NPI:1821578931
Name:PHILLIPPE, RENE MICHELLE (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:RENE
Middle Name:MICHELLE
Last Name:PHILLIPPE
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 ORCHARD RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:IN
Mailing Address - Zip Code:46714-2749
Mailing Address - Country:US
Mailing Address - Phone:260-820-0605
Mailing Address - Fax:
Practice Address - Street 1:424 ORCHARD RIDGE DR
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:IN
Practice Address - Zip Code:46714-2749
Practice Address - Country:US
Practice Address - Phone:260-820-0605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-17
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28170462A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily