Provider Demographics
NPI:1770723140
Name:BEAUCHAMP, LINDSEY ELIZABETH (DPT)
Entity type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:ELIZABETH
Last Name:BEAUCHAMP
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MISS
Other - First Name:LINDSEY
Other - Middle Name:ELIZABETH
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:28393 BRYANS STORE RD
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19947-5930
Mailing Address - Country:US
Mailing Address - Phone:410-208-3630
Mailing Address - Fax:
Practice Address - Street 1:11070 CATHELL RD STE 4
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:MD
Practice Address - Zip Code:21811-9344
Practice Address - Country:US
Practice Address - Phone:410-208-3630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-25
Last Update Date:2009-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ100024452251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE9000709DEOtherBLUE CROSS BLUE SHIELD OF DELAWARE