Provider Demographics
NPI:1992200141
Name:PHILLIPS, SCOTT CHRISTIAN (CRNA)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:CHRISTIAN
Last Name:PHILLIPS
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 S 1150 E
Mailing Address - Street 2:
Mailing Address - City:TREMONTON
Mailing Address - State:UT
Mailing Address - Zip Code:84337-6734
Mailing Address - Country:US
Mailing Address - Phone:801-592-2001
Mailing Address - Fax:
Practice Address - Street 1:950 S 500 W
Practice Address - Street 2:
Practice Address - City:BRIGHAM CITY
Practice Address - State:UT
Practice Address - Zip Code:84302-4724
Practice Address - Country:US
Practice Address - Phone:435-734-9471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-29
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCRNA-01540367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered