Provider Demographics
NPI:1386290997
Name:PHILLIPS, HELENE P
Entity type:Individual
Prefix:
First Name:HELENE
Middle Name:P
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 1:6624 DULCE REAL
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34951-4404
Mailing Address - Country:US
Mailing Address - Phone:772-448-8854
Mailing Address - Fax:
Practice Address - Street 1:6624 DULCE REAL
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34951-4404
Practice Address - Country:US
Practice Address - Phone:772-448-8854
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-11
Last Update Date:2019-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion