Provider Demographics
NPI:1851952527
Name:PHILLIPS, RACQUEL
Entity Type:Individual
Prefix:
First Name:RACQUEL
Middle Name:
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 40913
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45240-0913
Mailing Address - Country:US
Mailing Address - Phone:513-445-3530
Mailing Address - Fax:
Practice Address - Street 1:736 NORTHLAND BLVD APT D
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45240-3149
Practice Address - Country:US
Practice Address - Phone:513-445-3530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-24
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health