Provider Demographics
NPI:1891376141
Name:PHILLIPS, FRANCES SOPHIA (RN)
Entity Type:Individual
Prefix:MS
First Name:FRANCES
Middle Name:SOPHIA
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:FRANCES
Other - Middle Name:SOPHIA
Other - Last Name:GOODSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FRANCES S GOODSON
Mailing Address - Street 1:1215 P ST
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95341-5829
Mailing Address - Country:US
Mailing Address - Phone:209-386-3294
Mailing Address - Fax:
Practice Address - Street 1:1215 P ST
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95341-5829
Practice Address - Country:US
Practice Address - Phone:209-386-3294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-19
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA617415163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA92701595F40203OtherMEDICAL