Phelps, Phyllis L

Phelps, Phyllis L is an individual health care provider with primary practice located at 1805 Hennepin Ave N , Glencoe MN 55336-1416. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Phelps, Phyllis L can be contacted via phone (320) 864-3121.

Contact Information

Primary practice address
1805 Hennepin Ave N Glencoe MN 55336-1416
Phone: (320) 864-3121
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X CNP 4348 Minnesota
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 9232460 Florida

Profile Details

NPI number 1770681595
LBN Legal business name Phelps, Phyllis L
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2006
Last updated Mar 4th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770681595 NPPES
Florida MEDICAID 307400500

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