Individual
KIZZY OLIVER EDMOND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
2121A BELLEVUE RD, DUBLIN, GA 31021-2998
(478) 272-1190
(478) 274-7628
Mailing address
854 SHADY GROVE CHURCH RD, DUBLIN, GA 31021-1052
(478) 278-8201
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
230365
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300030912A
—
GA
Enumeration date
04/20/2015
Last updated
08/22/2023
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