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
Phone: (917) 843-8386
Fax:
Website:
Health care specialties
| Specialty | Code | License # | 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 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1912478868 | NPPES |
| Georgia | Other | F10181019 | CERTIFICATION |
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