Provider Demographics
NPI:1134796873
Name:PHILLIPS, BRITTANY (FNP)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 CRYSTAL SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:OWINGSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40360-7047
Mailing Address - Country:US
Mailing Address - Phone:859-585-9886
Mailing Address - Fax:
Practice Address - Street 1:105 CRYSTAL SPRINGS DR
Practice Address - Street 2:
Practice Address - City:OWINGSVILLE
Practice Address - State:KY
Practice Address - Zip Code:40360-7047
Practice Address - Country:US
Practice Address - Phone:859-585-9886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3016096363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily