Healthcare Provider Details

I. General information

NPI: 1447921192
Provider Name (Legal Business Name): LINDA JONES BEAUREGARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2021
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

708 W FOREST AVE
JACKSON TN
38301-3957
US

IV. Provider business mailing address

9201 ARBORETUM PKWY STE 300
NORTH CHESTERFIELD VA
23236-5407
US

V. Phone/Fax

Practice location:
  • Phone: 731-267-2214
  • Fax:
Mailing address:
  • Phone: 804-520-4600
  • Fax: 833-525-0063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024195489
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number30294
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: