Individual
JENNIFER BEAUDREAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1350 WALTON WAY, EMERGENCY DEPT UNIVERSITY HOSPITAL, AUGUSTA, GA 30901-2612
(706) 774-2223
Mailing address
PO BOX 1399, EVANS, GA 30809-1399
(706) 447-1280
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
31002
AZ
208M00000X
Hospitalist Physician
31002
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
746092
—
AZ
Enumeration date
05/19/2006
Last updated
03/19/2008
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