Individual
DEBRA A BEAUCHAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
250 E DUNLAP AVE, PHOENIX, AZ 85020-2825
(602) 870-6060
(602) 216-5633
Mailing address
250 E DUNLAP AVE, PHOENIX, AZ 85020-2825
(602) 870-6060
(602) 216-5633
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
AP3262
AZ
363LG0600X
Gerontology Nurse Practitioner
AP30004269
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039581
LABOR AND INDUSTRIES #
WA
01
—
3688BE
BLUE SHIELD#
WA
05
—
9638552
—
WA
01
—
US7777426
AETNA SPECIALIST PIN
WA
Enumeration date
02/02/2007
Last updated
10/23/2013
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