Phillips, Carlisa Jane

Phillips, Carlisa Jane is an individual health care provider with primary practice located at 5840 S Memorial Dr Ste 301 , Tulsa OK 74145-9082. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Phillips, Carlisa Jane can be contacted via phone (918) 699-4250.

Contact Information

Primary practice address
5840 S Memorial Dr Ste 301 Tulsa OK 74145-9082
Phone: (918) 699-4250
Fax: (918) 921-8824
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 64636 Oklahoma

Profile Details

NPI number 1679872857
LBN Legal business name Phillips, Carlisa Jane
Credentials APRN-CNP
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 27th, 2011
Last updated Sep 16th, 2022 - about 4 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 1679872857 NPPES
Oklahoma MEDICAID 200335850A

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