Active NPI
Debra A Beauchaine, ANP
- Adult Health Nurse Practitioner
- Phoenix, AZ
National Provider Identifier
1275671901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- AP3262
- Practice address
- 250 E Dunlap Ave
Phoenix, AZ 85020-2825 - Phone
- (602) 870-6060
- Fax
- (602) 216-5633
- NPI assigned
- Feb 2, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | AP30004269 | WA | |
| Adult Health Nurse Practitioner | 363LA2200X | AP3262 | AZ | Primary |
Addresses
Primary practice location
250 E Dunlap Ave
Phoenix, AZ 85020-2825
Mailing address
250 E Dunlap Ave
Phoenix, AZ 85020-2825
Phone (602) 870-6060
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0039581 | Other | WA | LABOR AND INDUSTRIES # |
| 3688BE | Other | WA | BLUE SHIELD# |
| US7777426 | Other | WA | AETNA SPECIALIST PIN |
| 9638552 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1382486400000",
"number": "1275671901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 E DUNLAP AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850202825",
"telephone_number": "602-870-6060",
"fax_number": "602-216-5633"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 E DUNLAP AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850202825",
"telephone_number": "602-870-6060",
"fax_number": "602-216-5633"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEAUCHAINE",
"first_name": "DEBRA",
"middle_name": "A",
"credential": "ANP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-02",
"last_updated": "2013-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "WA",
"license": "AP30004269",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "AZ",
"license": "AP3262",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR AND INDUSTRIES #",
"identifier": "0039581",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD#",
"identifier": "3688BE",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA SPECIALIST PIN",
"identifier": "US7777426",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9638552",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.