Provider Demographics
NPI:1508234717
Name:BEUCHERIE, CHRISTOPHER J
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:J
Last Name:BEUCHERIE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 GALLETTI WAY
Mailing Address - Street 2:BUILDING 2A
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-5564
Mailing Address - Country:US
Mailing Address - Phone:775-303-9807
Mailing Address - Fax:
Practice Address - Street 1:4773 CAUGHLIN PKWY STE 2
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89519-1012
Practice Address - Country:US
Practice Address - Phone:775-303-9807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-03
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker