HEATHER L BEAUDRY (NPI# 1760464937) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760464937 |
| Entity Type | Individual |
| Full Name | HEATHER L BEAUDRY |
| Credential | PHD |
| Practice Address |
1907 N Roan St Ste 207 Johnson City TN 37601-3182 |
| Mailing Address |
1755 Oregon Pike Suite 200 Lancaster PA 17601 |
| Practice Telephone | 4232820164 |
| Practice Fax Number | 4233884858 |
| Mailing Telephone | 7175815255 |
| Mailing Fax Number | 7175815259 |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2019-03-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
TN2735 | TN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | BLUE SHIELD | 042017 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770199150 | Heather Lee Beaudry | Registered Nurse | 133 Pleasant St, Berlin, NH 03570-2006 | 2020-09-21 |
| Street Address |
1907 N ROAN ST STE 207 |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37601-3182 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396381992 | Juan Carlos Simon Villegas Gomez | Specialist/Technologist | 1081 John Robert Bell Dr, Johnson City, TN 37601 | 2019-11-19 |
| 1629537279 | Jaima Suzanne Price | Hearing Instrument Specialist | 106 E Watauga Avenue, Johnson City, TN 37601 | 2019-03-13 |
| 1275004467 | Brittany Howell | Speech-Language Pathologist | 2114 E. Fairview Ave, Johnson City, TN 37601 | 2018-12-16 |
| 1194229948 | Heather Chantel Lester | Physical Therapist | 2114 E. Fairview Avenue, Johnson City, TN 37601 | 2018-03-19 |
| 1477061869 | Patrick Conway Reynolds | Specialist/Technologist | 1081 John Robert Bell Drive, Johnson City, TN 37601 | 2018-01-19 |
| 1790201135 | Surgical Services of East Tennessee PC | Surgery | 300 East Main St., Suite 301, Johnson City, TN 37601 | 2017-08-17 |
| 1073065694 | Davina Leah Reppond | Home Health | 1204 E Myrtle Ave, Johnsoncity, TN 37601 | 2016-10-31 |
| 1003365503 | Wendi Y Minutolo | Behavioral Analyst | 403 Princeton Rd Ste 3, Johnson City, TN 37601 | 2016-09-25 |
| 1306208798 | Rachel Anne Anderson | Nurse Practitioner | 1118 East Holston Avenue, Johnson City, TN 37601 | 2016-03-24 |
| 1932560976 | Kaydee Louise Davidson | Occupational Therapist | 3209 Bristol Highway, Johnson City, TN 37601 | 2016-03-18 |
| Find all providers in zip 37601 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881220697 | Rachel Miller Slough | Psychologist | 801 S Dossett Drive, Johnson City, TN 37614 | 2020-03-13 |
| 1548692692 | Jason Lee Steadman | Psychologist | 1193 Jack Vest Dr, Behavioral Health and Wellness Clinic, Johnson City, TN 37614-6505 | 2013-07-31 |
| 1649345208 | Matthew David Johnson | Psychologist | 240 Riverside Dr Ste 2, Johnson City, NY 13790-2732 | 2006-11-21 |
| 1588670210 | Stephen L. Owens | Psychologist | 302 Sunset Dr Ste 106, Johnson City, TN 37604-2408 | 2006-08-01 |
| 1467476150 | Tedd A Stephens | Psychologist | 2112 N Roan St Fl 6, Johnson City, TN 37601-2519 | 2006-07-26 |
| 1790717411 | Nancy L Lanthorn | Psychologist | 704 E Watauga Ave, Johnson City, TN 37601-4112 | 2006-07-06 |
| 1811960644 | Kerry L. Holland | Psychologist | 807 University Pkwy, 139 Lucille Clement Hall, Johnson City, TN 37614-6500 | 2006-02-10 |
| 1770197766 | Mary Ann Moore | Psychologist | 679 Main St, Johnson City, NY 13790-1716 | 2020-09-07 |
| 1184232605 | Bess Summerlin Lewis | Psychologist | Lamont St & Veterans Way, Johnson City, TN 37604 | 2020-07-21 |
| 1245856566 | Meredith K Ginley | Psychologist | 166 Derosier Dr, Johnson City, TN 37614-5200 | 2020-06-23 |
| Find all providers in JOHNSON CITY | ||||
| City | JOHNSON CITY |
| Zip Code | 37601 |
Please comment or provide details below to improve the information on HEATHER L BEAUDRY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.