Provider Demographics
NPI:1659529303
Name:NDE, BEATRICE ANIH (NP)
Entity Type:Individual
Prefix:
First Name:BEATRICE
Middle Name:ANIH
Last Name:NDE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1655 MILLHOUSE LNDG
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-8032
Mailing Address - Country:US
Mailing Address - Phone:678-494-5842
Mailing Address - Fax:
Practice Address - Street 1:460 NORTHSIDE CHEROKEE BLVD STE 130
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30115-8017
Practice Address - Country:US
Practice Address - Phone:678-493-2527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-07
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN149109363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care