Provider Demographics
NPI:1568963403
Name:PHILLIPS, RANDEE (APRN-CNP)
Entity type:Individual
Prefix:
First Name:RANDEE
Middle Name:
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:816 W DAVIS
Mailing Address - Street 2:
Mailing Address - City:PAOLI
Mailing Address - State:OK
Mailing Address - Zip Code:73074-9721
Mailing Address - Country:US
Mailing Address - Phone:405-205-6250
Mailing Address - Fax:405-205-6250
Practice Address - Street 1:3825 N LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-3316
Practice Address - Country:US
Practice Address - Phone:303-500-1518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-26
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK85898363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily