Krisshelle Ann Phelps, LVN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

175775 Issued in TX

Practice address

711 S Muskogee Ave
Tahlequah, OK 74464-4717

Phone

(405) 583-7833

NPI assigned

Sep 18, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1124806443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 N PECAN ST",
            "city": "CLARKSVILLE",
            "state": "TX",
            "postal_code": "754263013",
            "telephone_number": "903-280-2878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 S MUSKOGEE AVE",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744644717",
            "telephone_number": "405-583-7833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "KRISSHELLE",
        "middle_name": "ANN",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-18",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "TX",
            "license": "175775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Herbert J. Perkins
• Sara Kay Perry, LMSW
• Taylor Perry
• Kendra Pettit, ATC
• Amy Pham, DO
• Jennifer Phillips, R.N.
• Jennifer Lee Phillips, OUTREACH COORDINATOR
• Kadesha Phillips, CNA/CHHA
• Kent Darlin Phillips
• Sherlyn Phillips, BHRS

• Licensed Practical Nurse in Tahlequah, OK
• Providers in Tahlequah, OK by specialty
• Licensed Practical Nurse in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.