Provider Demographics
NPI:1275916629
Name:BROWN, RUTH QUICKE (MSN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:QUICKE
Last Name:BROWN
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1624 MARS HILL RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-4813
Mailing Address - Country:US
Mailing Address - Phone:706-310-1030
Mailing Address - Fax:
Practice Address - Street 1:1624 MARS HILL RD
Practice Address - Street 2:SUITE B
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-4813
Practice Address - Country:US
Practice Address - Phone:706-310-1030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-02
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN224069363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner