Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | MA02065900 | NJ |
NPI | 1215018304 |
---|---|
Provider Name | Nancy Lee Phillips |
First Address | Voorhees, NJ 08043-8303 |
Second Address | Mount Laurel, NJ 08054-6299 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 19/01/2012 |