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General NPI Number Information
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NPI Number | 1275671901
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Entity Type | Individual
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Provider Name | DEBRA A BEAUCHAINE ANP
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Gender | Female
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 10/23/2013
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Provider Practice Location Address
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Address Line | 250 E DUNLAP AVE
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City | PHOENIX
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State | AZ
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Zip | 85020-2825
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Country | US
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Telephone | 602-870-6060
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Fax | 602-216-5633
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Provider Business Mailing Address
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Address Line | 250 E DUNLAP AVE
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City | PHOENIX
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State | AZ
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Zip | 85020-2825
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Country | US
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Telephone | 602-870-6060
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Fax | 602-216-5633
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | AP30004269
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | AP3262
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License Number State | AZ
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