Conn, Alicia Marie

Conn, Alicia Marie is an sole proprietor health care provider with primary practice located at 1610 Alice Street , Waycross GA 31501-4533. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Conn, Alicia Marie can be contacted via phone (912) 584-3263.

Contact Information

Primary practice address
1610 Alice Street Waycross GA 31501-4533
Phone: (912) 584-3263
Fax: (912) 809-2296
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X RN230326 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 000000 Georgia

Profile Details

NPI number 1538604368
LBN Legal business name Conn, Alicia Marie
Credentials FNP, PMHNP-BC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 3rd, 2017
Last updated Feb 8th, 2024 - about 10 months 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 1538604368 NPPES
Georgia MEDICAID 003254260A

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