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:
Health care specialties
Specialty | Code | License # | 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 9 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1538604368 | NPPES |
Georgia | MEDICAID | 003254260A |
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