Glenda Patricia Menendez, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN291887 Issued in GA

Practice address

639 Beaver Ruin Rd NW Ste a
Lilburn, GA 30047-3473

Phone

(678) 395-3443

NPI assigned

Jun 27, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Premium Life Medical Center LLC

  • Primary Care Clinic/Center
  • Lilburn, GA
  • NPI 1275233611
  NPD
• Clinica Familiar Vida Y Salud

  • Primary Care Clinic/Center
  • Lilburn, GA
  • NPI 1679336234
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1687824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1891471322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "639 BEAVER RUIN RD NW STE A",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300473473",
            "telephone_number": "678-395-3442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "639 BEAVER RUIN RD NW STE A",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300473473",
            "telephone_number": "678-395-3443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENENDEZ",
        "first_name": "GLENDA",
        "middle_name": "PATRICIA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-27",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN291887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denise Meadows
• Medcare Tech LLC
• Medilag Neonatology, PC
• Medilag Pediatrics
• Medpro Independent Living LLC
• Joy Caroline Merchan, M.ED., CCC-SLP & LPN
• Metro1Homecare
• Michael E Mayfield MD and Assoc PC
• Theodore Miko, D.O.
• Keiasya Breona Miles

• Family Nurse Practitioner in Lilburn, GA
• Providers in Lilburn, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.