Healthcare Provider Details

I. General information

NPI: 1619853660
Provider Name (Legal Business Name): MEGAN BEAULIEU APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2025
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ELLIOT WAY
MANCHESTER NH
03103-3599
US

IV. Provider business mailing address

1 ELLIOT WAY
MANCHESTER NH
03103-3599
US

V. Phone/Fax

Practice location:
  • Phone: 603-669-5300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number069984-23
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number069984-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: