Phillips, Kelly W.

Phillips, Kelly W. is an individual health care provider with primary practice located at 3001 W Dr Martin Luther King Jr Blvd Fl 1 , Tampa FL 33607-6307. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Pediatrics, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Physician Assistants & Advanced Practice Nursing Providers / Pediatrics is her primary health care specialty. Phillips, Kelly W. can be contacted via phone (813) 870-4619.

Contact Information

Primary practice address
3001 W Dr Martin Luther King Jr Blvd Fl 1 Tampa FL 33607-6307
Phone: (813) 870-4619
Fax: (813) 554-8956
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Pediatrics 163WP0200X ARNP9300213 Florida
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X APRN9300213 Florida

Profile Details

NPI number 1184158719
LBN Legal business name Phillips, Kelly W.
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 20th, 2017
Last updated Nov 17th, 2023 - about last year

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 1184158719 NPPES
Florida MEDICAID 021409700

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