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General NPI Number Information
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NPI Number | 1750040788
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Entity Type | Individual
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Provider Name | LATOYA MARIA BEAUCHAMP NP
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Gender | Female
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Dates
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Enumeration Date | 12/17/2021
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 2124 CANDLER RD
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City | DECATUR
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State | GA
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Zip | 30032-5572
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Country | US
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Telephone | 404-836-0272
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Fax |
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Provider Business Mailing Address
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Address Line | 501 LAPALCO BLVD
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City | GRETNA
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State | LA
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Zip | 70056-7336
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Country | US
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Telephone | 504-393-4376
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Fax | 504-930-4307
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN-NP219588
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License Number State | GA
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