NPI 1104434950

Mandie Marie Phillips, LPN

Practitioner Licensed Practical Nurse Boise, ID

Practice location

Address: 500 W Fort St, Boise, ID 83702-4501
Phone: (208) 422-1000
Fax: (208) 422-1051

Registered specialties

Licensed Practical Nurse Primary

Nursing Service Providers Taxonomy 164W00000X Licence 15151 (ID)

Other Licensed Practical Nurse providers in Idaho →

Registry record

NPI: 1104434950
Entity type: Individual
Sex (as registered): Female
NPI issued: 17 Jul 2020
Record last updated: 17 Jul 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.