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Individual

AMBER FAITH BEAUCHAMP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
4420 LAKE BOONE TRL, RALEIGH, NC 27607-7505
(919) 784-3100
Mailing address
585 LEROY ST, FERNDALE, MI 48220-3300
(248) 918-9573

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
4704306567
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
6584
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
125682
NBCRNA
01
19072090337
MI RN LICENSE
MI
01
331335
NC RN LICENSE
NC
01
6584
NC CRNA LICENSE
NC
Enumeration date
08/16/2018
Last updated
06/17/2025
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