Individual
MRS. BEVERLY D. ROSEBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1733 LAKE ROCKAWAY RD NW, CONYERS, GA 30012-3152
(404) 748-4123
(866) 340-9148
Mailing address
PO BOX 4715, ATLANTA, ATLANTA, GA 30302-4715
(404) 748-4123
(866) 340-9148
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
RN065472
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000735314C
PEACHSTATE HEALTH PLANS
—
05
—
000735314C
—
GA
01
—
10039885
AMERIGROUP
GA
01
—
319492
WELLCARE
GA
Enumeration date
01/26/2007
Last updated
07/06/2009
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