Provider Demographics
NPI:1215137369
Name:MATHEWS, PHYLLIS ADAMS (WHNP-BC)
Entity type:Individual
Prefix:
First Name:PHYLLIS
Middle Name:ADAMS
Last Name:MATHEWS
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:PHYLLIS
Other - Middle Name:ELAINE
Other - Last Name:MUNN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:724 SOUTH MASON ST
Mailing Address - Street 2:MSC 7901
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22807
Mailing Address - Country:US
Mailing Address - Phone:540-568-6178
Mailing Address - Fax:540-568-6176
Practice Address - Street 1:724. SOUTH MASON ST.
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22807
Practice Address - Country:US
Practice Address - Phone:540-568-6178
Practice Address - Fax:540-568-6176
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024167255363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology