Healthcare Provider Details

I. General information

NPI: 1669564993
Provider Name (Legal Business Name): BEVERLY ANN DINKINS LEARMONT FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1750 JESSE JEWELL PKWY SE
GAINESVILLE GA
30501-2566
US

IV. Provider business mailing address

4154 TATTERSHALL DR
DECATUR GA
30034-5355
US

V. Phone/Fax

Practice location:
  • Phone: --
  • Fax:
Mailing address:
  • Phone: 770-808-0886
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN 064892 NP
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: