Individual
CICELY A ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1133 EAGLES LANDING PKWY, STOCKBRIDGE, GA 30281-5085
(678) 604-1053
Mailing address
600 CELEBRATE LIFE PKWY, NEWNAN, GA 30265-8001
(770) 400-6296
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN177619
GA
363LA2200X
Adult Health Nurse Practitioner
Primary
RN177619
GA
Other
Enumeration date
08/29/2017
Last updated
03/31/2021
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