Individual
DENISE ALICIA MICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
677 CHURCH ST WELLSTAR KENNESTONE HOSPITAL, MARIETTA, GA 30060
(678) 923-8877
Mailing address
677 CHURCH ST WELLSTAR KENNESTONE HOSPITAL, MARIETTA, GA 30060
(678) 923-8877
Taxonomy
Speciality
Code
Description
License number
State
163WN0800X
Neuroscience Registered Nurse
RN152372
GA
363LA2100X
Acute Care Nurse Practitioner
Primary
NCO-000008
GA
Other
Enumeration date
10/12/2019
Last updated
07/15/2022
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