Individual
MS. CAMILLE TISHA BROCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
EMORY UNIVERSITY HOSPITAL EMERGENCY DEPARTMENT, 1364 CLIFFTON ROAD, ATLANTA, GA 30322-1006
(404) 712-2000
Mailing address
2224 AUSTIN LAKE DR SE, SMYRNA, GA 30082-3380
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
RN184254NP
GA
363LF0000X
Family Nurse Practitioner
RN184254
GA
Other
Enumeration date
04/10/2008
Last updated
12/12/2022
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