Individual
CICELY KINISHA BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
805 LANIER AVE E, FAYETTEVILLE, GA 30214-2204
(770) 694-6349
Mailing address
3676 TAMPA TRL SW, ATLANTA, GA 30331-5308
(678) 662-2564
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
NCO-000003
GA
Other
Enumeration date
07/19/2024
Last updated
07/19/2024
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