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Individual

MAISHA LASHAWN BEAUCHAMP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1434 MAIN ST STE A, BAKER, LA 70714-2838
(225) 522-0502
Mailing address
1434 MAIN ST STE A, BAKER, LA 70714-2838
(225) 522-0502

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
010781841
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
842737387
LA
Enumeration date
06/02/2022
Last updated
06/02/2022
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