Provider Demographics
NPI:1629047592
Name:BECHTLE, JEANMARIE (DNP, ANP-BC, CCD)
Entity Type:Individual
Prefix:DR
First Name:JEANMARIE
Middle Name:
Last Name:BECHTLE
Suffix:
Gender:F
Credentials:DNP, ANP-BC, CCD
Other - Prefix:
Other - First Name:JEANMARIE
Other - Middle Name:
Other - Last Name:LOCKWOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:KOHL'S WELLNESS CENTER -MANAGED BY QUAD MEDICAL
Mailing Address - Street 2:300 ADMIRAL BYRD DRIVE
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22602
Mailing Address - Country:US
Mailing Address - Phone:540-723-4069
Mailing Address - Fax:540-535-7278
Practice Address - Street 1:190 CAMPUS BLVD
Practice Address - Street 2:STE 420
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2872
Practice Address - Country:US
Practice Address - Phone:540-931-0400
Practice Address - Fax:540-667-9453
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024105790363LA2200X
MDAC000498363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
P91224Medicare UPIN
MDKN96Medicare PIN
VA004733A67Medicare ID - Type Unspecified