Provider Demographics
NPI:1891048385
Name:BEAUMARCHAIS, LAUREN (PA-C)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:BEAUMARCHAIS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:718 E COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-2032
Mailing Address - Country:US
Mailing Address - Phone:615-560-7016
Mailing Address - Fax:615-560-7017
Practice Address - Street 1:718 E COLLEGE ST
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-2032
Practice Address - Country:US
Practice Address - Phone:615-560-7016
Practice Address - Fax:615-560-7017
Is Sole Proprietor?:No
Enumeration Date:2012-10-21
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA22601363A00000X
TN5604363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant