Shi Jean Phillips, LVN
Individual provider Active NPI Licensed Vocational Nurse · Brady, TX
NPI 1871093641 · NPPES record last updated Feb 18, 2018
Key facts
- NPI
- 1871093641
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Vocational Nurse 164X00000X
- License
- 308839 (TX)
- Practice address
- 1104 S Church St
Brady, TX 76825-6234 - Phone
- (325) 792-7480
- NPI assigned
- Feb 18, 2018
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 308839 | TX | MD | Licensed Vocational Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Vocational Nurse | 164X00000X | 308839 | TX | Yes |
Addresses
Primary practice location
1104 S Church St
Brady, TX 76825-6234
Mailing address
1104 S Church St
Brady, TX 76825-6234
Phone (325) 793-7024
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 308839 | Medicaid | TX |
Other providers in Brady, TX
- Karla Moerbe
- Baile Brean Morris
- Michael Edgar Nesbitt
- Norma'S Home Health
- Tracy A. Penn
- Harper Neal Price
- Deborah Christine Probst
- Dorothy Lee Richardson
- Royal Oaks Assisted Living
- Rubye B Lewallen
All providers in Brady, TX · Licensed Vocational Nurse in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 18, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.