Provider Demographics
NPI:1487934014
Name:CHAMPNEY, BEATRICE MADELEINE (RN)
Entity type:Individual
Prefix:MS
First Name:BEATRICE
Middle Name:MADELEINE
Last Name:CHAMPNEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3304 SHASTA DAM BLVD
Mailing Address - Street 2:SP. 58
Mailing Address - City:SHASTA LAKE
Mailing Address - State:CA
Mailing Address - Zip Code:96019-9583
Mailing Address - Country:US
Mailing Address - Phone:530-227-1962
Mailing Address - Fax:
Practice Address - Street 1:1716 COURT ST
Practice Address - Street 2:SUITE B
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-1762
Practice Address - Country:US
Practice Address - Phone:530-223-2332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-26
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA417782163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse