Provider Demographics
NPI:1700608858
Name:PHILLIPS, CATHY SMITH (AANP-C)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:SMITH
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:AANP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7120 BRITISH RD
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-5505
Mailing Address - Country:US
Mailing Address - Phone:423-505-2880
Mailing Address - Fax:
Practice Address - Street 1:7120 BRITISH RD
Practice Address - Street 2:
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-5505
Practice Address - Country:US
Practice Address - Phone:423-505-2880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN37422363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily