Provider Demographics
NPI:1497190748
Name:HOSKINS, PHILLIP DOUGLAS (LPN)
Entity type:Individual
Prefix:MR
First Name:PHILLIP
Middle Name:DOUGLAS
Last Name:HOSKINS
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3121 DORF DR
Mailing Address - Street 2:
Mailing Address - City:MORAINE
Mailing Address - State:OH
Mailing Address - Zip Code:45439-7904
Mailing Address - Country:US
Mailing Address - Phone:937-546-9790
Mailing Address - Fax:
Practice Address - Street 1:3121 DORF DR
Practice Address - Street 2:
Practice Address - City:MORAINE
Practice Address - State:OH
Practice Address - Zip Code:45439-7904
Practice Address - Country:US
Practice Address - Phone:937-546-9790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-30
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.131318-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse