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General NPI Number Information
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NPI Number | 1710670641
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Entity Type | Individual
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Provider Name | GINNEY MARY BELADJIAN MSN, FNP
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Gender | Female
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Dates
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Enumeration Date | 05/26/2023
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Last Update Date | 05/26/2023
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Provider Practice Location Address
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Address Line | 1505 WILSON TER STE 340
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City | GLENDALE
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State | CA
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Zip | 91206-4072
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Country | US
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Telephone | 818-543-7574
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Fax | 818-956-7609
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Provider Business Mailing Address
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Address Line | 1505 WILSON TER STE 340
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City | GLENDALE
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State | CA
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Zip | 91206-4072
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Country | US
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Telephone | 818-543-7574
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Fax | 818-956-7609
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95025345
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License Number State | CA
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