Provider Demographics
NPI:1053505768
Name:PHILLIPS, CHINA HENRY (APRN, BC)
Entity type:Individual
Prefix:MRS
First Name:CHINA
Middle Name:HENRY
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7020 MOON RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-4900
Mailing Address - Country:US
Mailing Address - Phone:706-569-7992
Mailing Address - Fax:706-569-8560
Practice Address - Street 1:7020 MOON ROAD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909
Practice Address - Country:US
Practice Address - Phone:706-569-7992
Practice Address - Fax:706-569-8560
Is Sole Proprietor?:No
Enumeration Date:2007-09-05
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN141185363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily