Provider Demographics
NPI:1669564993
Name:DINKINS LEARMONT, BEVERLY ANN (FNP)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:ANN
Last Name:DINKINS LEARMONT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4154 TATTERSHALL DR
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30034-5355
Mailing Address - Country:US
Mailing Address - Phone:770-808-0886
Mailing Address - Fax:
Practice Address - Street 1:3361 GRANT RD
Practice Address - Street 2:
Practice Address - City:CONLEY
Practice Address - State:GA
Practice Address - Zip Code:30288-2133
Practice Address - Country:US
Practice Address - Phone:678-244-7933
Practice Address - Fax:404-800-0016
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN 064892 NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1669564993OtherNPPES