Provider Demographics
NPI:1518714153
Name:PHILLIPS, HOLLI
Entity type:Individual
Prefix:
First Name:HOLLI
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 1:6408 MEADOWBROOK DR
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-3668
Mailing Address - Country:US
Mailing Address - Phone:828-357-7745
Mailing Address - Fax:
Practice Address - Street 1:525 LIBERTY LN
Practice Address - Street 2:
Practice Address - City:DALE
Practice Address - State:TX
Practice Address - Zip Code:78616-2158
Practice Address - Country:US
Practice Address - Phone:440-897-8069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-01
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula