Healthcare Provider Details

I. General information

NPI: 1952137028
Provider Name (Legal Business Name): LINDSAY BETH BEAULIEU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2024
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

417 STATE STATE ST WEBBER EAST SUITE 421
BANGOR ME
04401
US

IV. Provider business mailing address

20 ROWELL RD
HOLDEN ME
04429-7259
US

V. Phone/Fax

Practice location:
  • Phone: 207-973-5293
  • Fax: 207-973-5263
Mailing address:
  • Phone: 207-949-0319
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCNP251405
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN53998
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: