Individual
KENNEDY BROOKE OSBORNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
888 PINE ST, MACON, GA 31201-2109
(478) 633-1000
Mailing address
888 PINE ST, MACON, GA 31201-2109
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN268261
GA
363LP0200X
Pediatric Nurse Practitioner
Primary
RN268261
GA
Other
Enumeration date
10/20/2022
Last updated
10/10/2025
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