Provider Demographics
NPI:1124169859
Name:BEERMAN, GLENDA N (RNFA)
Entity type:Individual
Prefix:
First Name:GLENDA
Middle Name:N
Last Name:BEERMAN
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 MISTY RIDGE MNR NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-4978
Mailing Address - Country:US
Mailing Address - Phone:404-255-6762
Mailing Address - Fax:404-252-5018
Practice Address - Street 1:2 MISTY RIDGE MNR NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-4978
Practice Address - Country:US
Practice Address - Phone:404-255-6762
Practice Address - Fax:404-252-5018
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN137810163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA52005740OtherBCBS