Healthcare Provider Details

I. General information

NPI: 1053178707
Provider Name (Legal Business Name): LAUREN BEAUCHAMP NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/29/2024
Last Update Date: 02/29/2024
Certification Date: 02/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1031 LAFAYETTE RD
NORTH KINGSTOWN RI
02852-6413
US

IV. Provider business mailing address

1031 LAFAYETTE RD
NORTH KINGSTOWN RI
02852-6413
US

V. Phone/Fax

Practice location:
  • Phone: 401-742-4479
  • Fax:
Mailing address:
  • Phone: 401-742-4479
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN03819
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60810
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: