1750639605 NPI number — BEATRICE MCLAUGHLIN CRNP

Table of content: BEATRICE MCLAUGHLIN CRNP (NPI 1750639605)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750639605 NPI number — BEATRICE MCLAUGHLIN CRNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCLAUGHLIN
Provider First Name:
BEATRICE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CRNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1750639605
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/12/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3000 COLISEUM DR STE 445
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAMPTON
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23666-5963
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-739-2009
Provider Business Mailing Address Fax Number:
877-432-6213

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3100 ALBERT LANKFORD DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LYNCHBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24501-4948
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
434-948-5300
Provider Business Practice Location Address Fax Number:
434-948-5275
Provider Enumeration Date:
08/27/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  1-072891 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 0024173512 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)