Provider Demographics
NPI:1396050167
Name:PHILLIPS, SARA J (FNP)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:J
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 1:2914 OATES DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75228-3914
Mailing Address - Country:US
Mailing Address - Phone:972-682-8917
Mailing Address - Fax:214-296-3255
Practice Address - Street 1:2914 OATES DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75228-3914
Practice Address - Country:US
Practice Address - Phone:972-682-8917
Practice Address - Fax:214-296-3255
Is Sole Proprietor?:No
Enumeration Date:2010-08-17
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX764354363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily