Stephanie McKinnie Beauchamp, APRN
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Chattahoochee, FL
NPI 1073148698 · NPPES record last updated Mar 4, 2020
Key facts
- NPI
- 1073148698
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- APRN11005911 (FL)
- Practice address
- 100 N Main St
Chattahoochee, FL 32324-1107 - Phone
- (850) 663-7501
- Fax
- (850) 669-7588
- NPI assigned
- Mar 4, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201105000634 | FL | Practitioner - Nurse Practitioner | 9335559178 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN11005911 | FL | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Department of Children and Families | Current | Accepting new patients | |
| Florida Department of Children and Families | Current |
Accepting new patients | |
| Florida Department of Children and Families | Current |
Accepting new patients |
Locations
100 N Main St
Bldg 1028
Chattahoochee, FL 32324
Phone (904) 330-2215
100 N Main St
Chattahoochee, FL 32324
Phone (850) 663-7001
7487 S State Road 121
Macclenny, FL 32063
Phone (904) 259-6211
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | APRN11005911 | FL | Yes |
Addresses
Primary practice location
100 N Main St
Chattahoochee, FL 32324-1107
Mailing address
7839 Howell Rd
Sneads, FL 32460-3819
Phone (850) 557-7169
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- Angelcare With a Vision
- Cristnei Aquino-Vado
- Adel S Bassel
- Kimberly Marie Bell
- Majeeda L Bouie
- Bread &Butter Homemaker and Companion Services LLC
- Tiffany Elisabeth Brown
- Tina Rena Brown
All providers in Chattahoochee, FL · Psychiatric/Mental Health Nurse Practitioner in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 4, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.