Individual
ERIC MICHAEL BEAULIEU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
2204 PAVILION DR STE 108, KINGSPORT, TN 37660-4651
(423) 392-6100
(423) 392-6159
Mailing address
2204 PAVILION DR STE 108, KINGSPORT, TN 37660-4651
(423) 392-6100
(423) 392-6159
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
29882
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q068089
—
TN
Enumeration date
07/19/2021
Last updated
11/18/2022
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