Provider Demographics
NPI:1801567003
Name:BROWN DAVIS, CECILE (NP)
Entity type:Individual
Prefix:MRS
First Name:CECILE
Middle Name:
Last Name:BROWN DAVIS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CECILE
Other - Middle Name:
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:121 MEADOW OAKS LN
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39209-2001
Mailing Address - Country:US
Mailing Address - Phone:601-405-9470
Mailing Address - Fax:
Practice Address - Street 1:101 COTTON ACRES DR
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MS
Practice Address - Zip Code:39056-9743
Practice Address - Country:US
Practice Address - Phone:601-405-9470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-27
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS904254363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily