Provider Demographics
NPI:1881138485
Name:PHILLIPS, PATIENCE
Entity type:Individual
Prefix:
First Name:PATIENCE
Middle Name:
Last Name:PHILLIPS
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 1:10979 REED HARTMAN HWY STE 132
Mailing Address - Street 2:
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45242-2800
Mailing Address - Country:US
Mailing Address - Phone:513-745-9270
Mailing Address - Fax:513-745-8368
Practice Address - Street 1:10979 REED HARTMAN HWY STE 132
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-2800
Practice Address - Country:US
Practice Address - Phone:513-745-9270
Practice Address - Fax:513-745-8368
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-15
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH81-1701998374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide