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Individual

MRS. REBECCA LOU BEAUCHAMP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
10081 FREDERICKSBURG RD NW, DEPAUW, IN 47115-8629
(812) 347-2568
(812) 347-2568
Mailing address
10081 FREDERICKSBURG RD NW, DEPAUW, IN 47115-8629
(812) 347-2568
(812) 347-2568

Taxonomy

Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
363A00000X
Physician Assistant
Primary
10002958A
IN
363AS0400X
Surgical Physician Assistant
PA2599
KY

Other

Enumeration date
08/23/2010
Last updated
04/11/2025
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