Provider Demographics
NPI:1730521121
Name:PHILLIPS, NATALLIA BORISOVNA (MSN, FNP-C)
Entity type:Individual
Prefix:
First Name:NATALLIA
Middle Name:BORISOVNA
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3751 W SPINNAKER LN
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85742-9216
Mailing Address - Country:US
Mailing Address - Phone:520-861-3416
Mailing Address - Fax:
Practice Address - Street 1:7089 N THORNYDALE RD STE 101
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-2728
Practice Address - Country:US
Practice Address - Phone:520-694-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-25
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ237692363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner