Provider Demographics
NPI:1790670719
Name:BEAUCHAINE, MARISA (RN)
Entity type:Individual
Prefix:
First Name:MARISA
Middle Name:
Last Name:BEAUCHAINE
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 1:55 W 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-5102
Mailing Address - Country:US
Mailing Address - Phone:720-237-1772
Mailing Address - Fax:
Practice Address - Street 1:77 W 5TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-5102
Practice Address - Country:US
Practice Address - Phone:720-237-1772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1623427163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management