Brown, Joan Icilda

Brown, Joan Icilda is an individual health care provider with primary practice located at 3341 Meadovista Dr , Ellenwood GA 30294-6638. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Primary Care. Physician Assistants & Advanced Practice Nursing Providers / Primary Care is her primary health care specialty. Brown, Joan Icilda can be contacted via phone (917) 843-8386.

Contact Information

Primary practice address
3341 Meadovista Dr Ellenwood GA 30294-6638
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X RN177358 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X RN177358 Georgia

Profile Details

NPI number 1912478868
LBN Legal business name Brown, Joan Icilda
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 17th, 2018
Last updated Dec 17th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912478868 NPPES
Georgia Other F10181019 CERTIFICATION

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