Provider Demographics
NPI:1386185999
Name:PHILLIPS, YVETTE MARYETTA (CNP)
Entity type:Individual
Prefix:MRS
First Name:YVETTE
Middle Name:MARYETTA
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3001 QUAIL SPRINGS PKWY FL 5
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-2640
Mailing Address - Country:US
Mailing Address - Phone:405-633-9101
Mailing Address - Fax:405-933-9104
Practice Address - Street 1:3435 NW 56TH ST STE 101
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4495
Practice Address - Country:US
Practice Address - Phone:405-633-9101
Practice Address - Fax:405-633-9104
Is Sole Proprietor?:No
Enumeration Date:2017-03-15
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0081834363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily