Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lychannel Ticole Head

Individual provider Specialist · NPI 1871163097

Lychannel Ticole Head is a Nurse Practitioner in McDonough, Georgia. Qualified in 2022, 4 years ago. Practices with Family Medical and Urgent Care Clinic of McDonough, LLC, a 20-clinician group. Licensed in Georgia.

Years since qualifying
4
Licensed in
GA
In the registry since
2021
Specialties on file
2

Practice location Address checks out

1631 Highway 20 W
McDonough, GA 30253-7311
Phone: (770) 288-2822
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 1952405052 (GA)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence F06211529 (GA)

Record details

NPI number1871163097
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 29, 2021
Last updated in NPPESJanuary 12, 2026
Certification dateJanuary 12, 2026
Mailing address1631 Highway 20 W, McDonough, GA 30253-7311

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Family Medical And Urgent Care Clinic Of McDonough, Llc — 20 clinicians
Accepts Medicare assignment Not indicated

Other providers in McDonough