Provider Demographics
NPI:1962800417
Name:BERNDT, ANGELA SUSANNE (RN218258)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:SUSANNE
Last Name:BERNDT
Suffix:
Gender:F
Credentials:RN218258
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Mailing Address - Street 1:131 RADIUM ST NW APT 4
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1369
Mailing Address - Country:US
Mailing Address - Phone:770-380-5835
Mailing Address - Fax:770-427-1492
Practice Address - Street 1:55 WHITCHER ST NE
Practice Address - Street 2:SUITE 460
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1155
Practice Address - Country:US
Practice Address - Phone:770-427-7389
Practice Address - Fax:770-427-1492
Is Sole Proprietor?:No
Enumeration Date:2014-12-16
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN218258363LA2100X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARN218258OtherRN LICENSE