Jeanne Carol Phillips, CNP

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

R16377 Issued in NM

Practice address

4640 Jefferson LN NE
Albuquerque, NM 87109-2116

Phone

(505) 843-6168

Fax

(505) 792-1978

NPI assigned

Jul 25, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595289600000",
    "number": "1285657064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6320 RIVERSIDE PLAZA LN NW STE B",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871201710",
            "telephone_number": "505-843-6168",
            "fax_number": "505-792-1978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4640 JEFFERSON LN NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871092116",
            "telephone_number": "505-843-6168",
            "fax_number": "505-792-1978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "JEANNE",
        "middle_name": "CAROL",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NM",
            "license": "R16377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90874",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aria Lynn Phillips
• Caren Phillips, OT
• Cierra Phillips
• Evan Phillips
• Gail Phillips, LMT
• Jennifer Phillips
• Jennifer Lynn Phillips, RN
• John Patrick Phillips, MD
• Josephine Phillips
• Joyce Phillips

• Women's Health Nurse Practitioner in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Women's Health Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2020; 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.