Healthcare Provider Details

I. General information

NPI: 1629047592
Provider Name (Legal Business Name): JEANMARIE BECHTLE DNP, ANP-BC, CCD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JEANMARIE LOCKWOOD CRNP

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 01/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 CAMPUS BLVD STE 420
WINCHESTER VA
22601-2872
US

IV. Provider business mailing address

KOHL'S WELLNESS CENTER -MANAGED BY QUAD MEDICAL 300 ADMIRAL BYRD DRIVE
WINCHESTER VA
22602
US

V. Phone/Fax

Practice location:
  • Phone: 540-931-0400
  • Fax: 540-667-9453
Mailing address:
  • Phone: 540-723-4069
  • Fax: 540-535-7278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number0024105790
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAC000498
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: