Provider Demographics
NPI:1326888256
Name:PHILLIPS, KARLA D
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:D
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 1:12313 ELK RIVER RD
Mailing Address - Street 2:
Mailing Address - City:DUCK
Mailing Address - State:WV
Mailing Address - Zip Code:25063
Mailing Address - Country:US
Mailing Address - Phone:304-651-2243
Mailing Address - Fax:
Practice Address - Street 1:101 2ND ST STE 201
Practice Address - Street 2:
Practice Address - City:SUTTON
Practice Address - State:WV
Practice Address - Zip Code:26601-1303
Practice Address - Country:US
Practice Address - Phone:304-765-3668
Practice Address - Fax:304-471-2488
Is Sole Proprietor?:No
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker