Individual
CICILY MONTENA HUSKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4350 TOWNE CENTRE DR STE 1100, EVANS, GA 30809-3329
(706) 863-3790
Mailing address
4180 BELLFLOWER DR, ALPHARETTA, GA 30005-6927
(678) 624-0044
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
RN138231
GA
363L00000X
Nurse Practitioner
Primary
RN138231
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0371565-22
BOARD CERTIFICATION
GA
05
—
979120850D
—
GA
05
—
979120850G
—
GA
05
—
979120850I
—
GA
Enumeration date
07/19/2006
Last updated
07/30/2024
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