Provider Demographics
NPI:1134008725
Name:PHILLIPS, ANNETTE (RN,BSN,MCHC)
Entity type:Individual
Prefix:
First Name:ANNETTE
Middle Name:
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:RN,BSN,MCHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:293 COLLINS RD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:SC
Mailing Address - Zip Code:29676-3814
Mailing Address - Country:US
Mailing Address - Phone:864-482-8173
Mailing Address - Fax:
Practice Address - Street 1:106 OWENS CIR
Practice Address - Street 2:
Practice Address - City:CENTRAL
Practice Address - State:SC
Practice Address - Zip Code:29630
Practice Address - Country:US
Practice Address - Phone:864-482-8173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-28
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC91794163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health