Provider Demographics
NPI:1376532390
Name:BEAUPRE, AMY L (APRN)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:L
Last Name:BEAUPRE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 OLD ETNA RD
Mailing Address - Street 2:DARTMOUTH HITCHCOCK - PRIMARY CARE
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03766-1937
Mailing Address - Country:US
Mailing Address - Phone:603-650-4000
Mailing Address - Fax:
Practice Address - Street 1:18 OLD ETNA RD
Practice Address - Street 2:DARTMOUTH HITCHCOCK - PRIMARY CARE
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03766-1937
Practice Address - Country:US
Practice Address - Phone:603-650-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH046404-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
361056OtherMVP
NP4747Medicare ID - Type Unspecified
361056OtherMVP