Healthcare Provider Details

I. General information

NPI: 1831661255
Provider Name (Legal Business Name): MICHELE BEAUCHAMP MSN, APRN, AGCNS-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/24/2018
Last Update Date: 12/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 WELLNESS WAY
MILFORD DE
19963-4364
US

IV. Provider business mailing address

705 LINDSAY LN
MILFORD DE
19963-2130
US

V. Phone/Fax

Practice location:
  • Phone: 302-430-5299
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2100X
TaxonomyAcute Care Clinical Nurse Specialist
License NumberLV-0000117
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: