SHELLEY-ANN BEAUBRUN (NPI# 1083010961) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083010961 |
| Entity Type | Individual |
| Full Name | SHELLEY-ANN BEAUBRUN |
| Credential | NP-C |
| Practice Address |
1017 Fayetteville Rd Se Ste A Atlanta GA 30316-2932 |
| Mailing Address |
463 Silverton Dr Mcdonough GA 30252-4222 |
| Practice Telephone | 4043244191 |
| Enumeration Date | 2014-11-05 |
| Last Update Date | 2020-03-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
RN193787 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1017 FAYETTEVILLE RD SE STE A |
| City | ATLANTA |
| State | GA |
| Zip Code | 30316-2932 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659902666 | Edmonia Sianneh Doe | Counselor | 1017 Fayetteville Rd Se Ste A, Atlanta, GA 30316-2932 | 2020-01-29 |
| 1417455155 | Jaime Nicole Hunn | Social Worker | 1017 Fayetteville Rd Se Ste A, Atlanta, GA 30316-2932 | 2018-01-29 |
| 1568823516 | Travis M Thompson | Counselor | 1017 Fayetteville Rd Se Ste A, Atlanta, GA 30316-2932 | 2016-03-17 |
| 1104296052 | Jaime Stepansky | Social Worker | 1017 Fayetteville Rd Se Ste A, Atlanta, GA 30316-2932 | 2015-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073156923 | Rakiya Williams | Counselor | 1030 Fayetteville Rd., Atlanta, GA 30316 | 2019-10-23 |
| 1215585815 | Madison Victoria Baugh | Counselor | Chris180, 1030 Fayetteville Rd, Atlanta, GA 30316 | 2019-08-28 |
| 1265089460 | Josee Dominque Muldrew | Counselor | 1030 Fayetteville Rd. Se, Atlanta, GA 30316 | 2019-08-22 |
| 1255984241 | Monique Overstreet | Counselor | 1030 Fayetteville Road, Atlanta, GA 30316 | 2019-07-19 |
| 1023573979 | Publix Super Markets, Inc. | Durable Medical Equipment & Medical Supplies | 905 Memorial Drive Se, Atlanta-fulton, GA 30316 | 2019-02-05 |
| 1740726454 | Jimmy Brian Sambula | Behavior Technician | 1017 Fayetteville Rd. Se, Atlanta, GA 30316 | 2017-01-19 |
| 1033665039 | Liberty Group Senior Services | Clinic/Center | 1879 Glenwood Avenue, Atlanta, GA 30316 | 2016-08-30 |
| 1043673650 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 800 Glenwood Ave Se, Atlanta, GA 30316 | 2016-03-31 |
| 1992143382 | Ayodele Osasona | Surgery | 2004 Oak Terrace Dr Se, Atlanta, GA 30316 | 2013-06-07 |
| 1891945721 | Denise Renee Cagle | Social Worker | 1471 Town Country Dr Se, Atlanta, GA 30316 | 2008-09-28 |
| Find all providers in zip 30316 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063053478 | Emily Elizabeth Adams | Nurse Practitioner | 887 W Marietta St Nw, Atlanta, GA 30318-5252 | 2019-10-07 |
| 1316461221 | Thera Donaldson | Nurse Practitioner | 550 Peachtree St Ne Fl St7, Atlanta, GA 30308-2247 | 2017-08-01 |
| 1063853133 | Tammy Felicia Blackmon | Nurse Practitioner | 270 17th St Nw Unit 2501, Atlanta, GA 30363-1218 | 2013-07-17 |
| 1629415880 | Gina Kim | Nurse Practitioner | 5673 Peachtree Dunwoody Rd Ste 300, Atlanta, GA 30342-1775 | 2013-05-29 |
| 1750559837 | Phyllis Powell Wright | Nurse Practitioner | 3037 Loridan Way Se, Atlanta, GA 30339-5710 | 2008-02-12 |
| 1710036686 | Amy D Imes | Nurse Practitioner | 1155 Perimeter Ctr Fl 11, Atlanta, GA 30338-5463 | 2007-01-09 |
| 1821106733 | Holly Lynne Brown | Nurse Practitioner | 925 Garrett St Se, Suite 313, Atlanta, GA 30316-6826 | 2006-08-29 |
| 1700496981 | Debra Beckum | Nurse Practitioner | 320 Parkway Dr Ne, Atlanta, GA 30312-1213 | 2020-08-03 |
| 1356803357 | Racheal Sowole | Nurse Practitioner | 303 Parkway Dr Ne, Atlanta, GA 30312-1212 | 2019-04-01 |
| 1982194114 | Samantha Castello | Nurse Practitioner | 550 Peachtree St Ne, Atlanta, GA 30308-2212 | 2018-05-14 |
| Find all providers in ATLANTA | ||||
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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.