BEVERLY WYNNE (NPI# 1083012561) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083012561 |
| Entity Type | Individual |
| Full Name | BEVERLY WYNNE |
| Credential | APRN |
| Practice Address |
677 Church St Ne Marietta GA 30060-1101 |
| Mailing Address |
4120 Brigade Trl Nw Kennesaw GA 30152-7722 |
| Practice Telephone | 7707929808 |
| Mailing Telephone | 7704246172 |
| Enumeration Date | 2014-12-15 |
| Last Update Date | 2014-12-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LN0005X |
Nurse Practitioner Specialization: Neonatal, Critical Care |
RN079004 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
677 CHURCH ST NE |
| City | MARIETTA |
| State | GA |
| Zip Code | 30060-1101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841285095 | Grace S Kim | Anesthesiology | 677 Church St Ne, Marietta, GA 30060-1101 | 2005-09-14 |
| 1205436425 | Lakesha Alexis | Nurse Practitioner | 677 Church St Ne, Marietta, GA 30060-1101 | 2020-10-27 |
| 1710594080 | Terrence Helms | Nurse Anesthetist, Certified Registered | 677 Church St Ne, Marietta, GA 30060-1101 | 2020-09-30 |
| 1063022481 | Laura Elliott | Registered Nurse | 677 Church St Ne, Marietta, GA 30060-1101 | 2020-08-01 |
| 1346868908 | Megan Grace Zimmerman | Anesthesiologist Assistant | 677 Church St Ne, Marietta, GA 30060-1101 | 2020-07-10 |
| 1578180535 | Devon Potler-jack | Anesthesiologist Assistant | 677 Church St Ne, Marietta, GA 30060-1101 | 2020-06-25 |
| 1740802032 | Noelle Shaw | Anesthesiologist Assistant | 677 Church St Ne, Marietta, GA 30060-1101 | 2020-05-11 |
| 1316567860 | Molly O'keeffe | Registered Nurse | 677 Church St Ne, Marietta, GA 30060-1101 | 2020-04-24 |
| 1740800317 | Sara Roberts | Registered Nurse | 677 Church St Ne, Marietta, GA 30060-1101 | 2020-04-23 |
| 1508486184 | Luke Bishop | Student in an Organized Health Care Education/Training Program | 677 Church St Ne, Marietta, GA 30060-1101 | 2020-04-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144845116 | Legacy Center for Spinal Surgery, LLC | Neurological Surgery | 1900 The Exchange, Ne, Suite 600, Marietta, GA 30060 | 2020-06-15 |
| 1407477193 | Michael Cynil Daniel | Counselor | 698 N Marietta, Pkwy, Marietta, GA 30060 | 2020-05-04 |
| 1285253401 | Cameron Thomas Kennelly | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne Attn:gme, Marietta, GA 30060 | 2020-04-09 |
| 1922640739 | Jeremiah George Blair | Physician Assistant | 61 Whitcher St Suite 2100, Marietta, GA 30060 | 2019-10-14 |
| 1164064945 | Denise Alicia Mick | Registered Nurse | 677 Church St Wellstar Kennestone Hospital, Marietta, GA 30060 | 2019-10-12 |
| 1184283772 | Iora Health Georgia, P.C. | Internal Medicine | 280 Cobb Pkwy Se, Suite 60, Marietta, GA 30060 | 2019-06-07 |
| 1346703212 | Caitlin Virginia Mueller | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne, Attn: Gme, Marietta, GA 30060 | 2019-04-08 |
| 1184187205 | Adero Francis | Student in an Organized Health Care Education/Training Program | Wellstar Kennestone Gme Internal Medicine Clinic, 833 Campbell Hill St Nw, Suite 250, Marietta, GA 30060 | 2019-04-08 |
| 1659832749 | Matthew Mozzo | Student in an Organized Health Care Education/Training Program | 677 Church Street / Lower Level, Gme Department / I.m., Marietta, GA 30060 | 2019-03-29 |
| 1245797430 | La'myia Spentz | Specialist | 109 Anderson St Ne, Suite 608, Marietta, GA 30060 | 2019-02-25 |
| Find all providers in zip 30060 | ||||
| Taxonomy Code | 363LN0005X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Neonatal, Critical Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164477139 | Julia Elaine Casey | Nurse Practitioner | 800 Kennesaw Ave Nw, Marietta, GA 30060-1051 | 2006-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902357866 | Carla Zimmerly | Nurse Practitioner | 1711 Tullie Circle, Atlanta, GA 30329 | 2016-10-17 |
| 1851709844 | Scott Anthony Sides | Nurse Practitioner | 88 Hardy St, Chatsworth, GA 30705-3231 | 2014-07-23 |
| 1659641058 | Christy Marie Gardner | Nurse Practitioner | 1120 15th St # 6033, Augusta, GA 30912-0004 | 2012-01-03 |
| 1578527479 | Rebecca Lynn Turner | Nurse Practitioner | Children's Hospital Navicent Health, 777 Hemlock Street, Macon, GA 31201 | 2006-04-17 |
| 1932721461 | Ashley Murry | Nurse Practitioner | 1711 Tullie Cir Ne, Atlanta, GA 30329-2305 | 2020-05-06 |
| 1881227940 | Ingried Albisu | Nurse Practitioner | 1405 Clifton Rd Ne, Atlanta, GA 30322-1060 | 2020-02-18 |
| 1407400427 | Rachel Mae Perlman | Nurse Practitioner | 1584 Tullie Cir Ne, Atlanta, GA 30329-2311 | 2019-07-29 |
| 1730660093 | Virginia Tittle Kee | Nurse Practitioner | 11 Upper Riverdale Rd Sw, Riverdale, GA 30274-2615 | 2018-08-24 |
| 1669968137 | Cheri Denise Robison | Nurse Practitioner | 777 Hemlock St, Macon, GA 31201-2102 | 2018-07-07 |
| 1669962684 | Hilary Antley Jones | Nurse Practitioner | 1711 Tullie Cir Ne, Atlanta, GA 30329-2305 | 2018-05-15 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.