Healthcare Provider Details

I. General information

NPI: 1841826195
Provider Name (Legal Business Name): LINDSAY MICHELLE BEAUDRY CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2020
Last Update Date: 11/06/2024
Certification Date: 11/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

264 PLEASANT ST
CONCORD NH
03301-2551
US

IV. Provider business mailing address

75 FRANCIS ST
BOSTON MA
02115-6106
US

V. Phone/Fax

Practice location:
  • Phone: 603-224-3368
  • Fax: 603-228-7268
Mailing address:
  • Phone: 617-732-5500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number146812
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN2350890
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number066584-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: