Provider Demographics
NPI:1700289345
Name:PHILLIPPS, GAIL
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:
Last Name:PHILLIPPS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:469 E MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1600
Mailing Address - Country:US
Mailing Address - Phone:215-750-4330
Mailing Address - Fax:
Practice Address - Street 1:40 MARTIN GROSS DR
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1616
Practice Address - Country:US
Practice Address - Phone:215-750-4330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-26
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN606019163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse