Healthcare Provider Details

I. General information

NPI: 1801567003
Provider Name (Legal Business Name): CECILE BROWN DAVIS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CECILE BROWN

II. Dates (important events)

Enumeration Date: 09/27/2021
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 COTTON ACRES DR
CLINTON MS
39056-9743
US

IV. Provider business mailing address

121 MEADOW OAKS LN
JACKSON MS
39209-2001
US

V. Phone/Fax

Practice location:
  • Phone: 601-405-9470
  • Fax:
Mailing address:
  • Phone: 601-405-9470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number904254
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: