Eva Marie Beaulieu, LAT, ATC
Individual provider Active NPI Athletic Trainer · Lagrange, GA
NPI 1285660746 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1285660746
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- AT001195 (GA)
- Practice address
- 601 Broad St
Lagrange, GA 30240-2955 - Phone
- (770) 722-4054
- NPI assigned
- Jun 24, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT001195 | GA | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT001195 | GA | Yes |
Addresses
Primary practice location
601 Broad St
Lagrange, GA 30240-2955
Mailing address
130 Brierwood CT
Fayetteville, GA 30215-4615
Phone (770) 722-4054
Other providers in Lagrange, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.