Phillips, Corliss Y

Phillips, Corliss Y is an sole proprietor health care provider with primary practice located at 1903 Plover Ave Apt A , Fort Pierce FL 34949-3446. She recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Licensed Practical Nurse, Nursing Service Related Providers / Homemaker, Nursing Service Related Providers / Adult Companion. Nursing Service Related Providers / Adult Companion is her primary health care specialty. Phillips, Corliss Y can be contacted via phone (772) 940-3736.

Contact Information

Primary practice address
1903 Plover Ave Apt A Fort Pierce FL 34949-3446
Phone: (772) 940-3736
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X 5195534 Florida
Nursing Service Related Providers / Homemaker 376J00000X 234020 Florida
Nursing Service Related Providers / Adult Companion 372600000X 234020 Florida

Profile Details

NPI number 1114597259
LBN Legal business name Phillips, Corliss Y
Credentials Licensed Practical Nurse (LPN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 30th, 2021
Last updated Jun 30th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114597259 NPPES
Florida MEDICAID 0622

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