Provider Demographics
NPI:1265428049
Name:RYMER, ANN G
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:G
Last Name:RYMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 69
Mailing Address - Street 2:
Mailing Address - City:BLUE RIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30513-0002
Mailing Address - Country:US
Mailing Address - Phone:706-258-4040
Mailing Address - Fax:706-258-4041
Practice Address - Street 1:11 OVERVIEW DR
Practice Address - Street 2:
Practice Address - City:BLUE RIDGE
Practice Address - State:GA
Practice Address - Zip Code:30513-6611
Practice Address - Country:US
Practice Address - Phone:706-258-4040
Practice Address - Fax:706-258-4041
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN095475367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA43ZCBMT02Medicare ID - Type Unspecified