Provider Demographics
NPI:1144863234
Name:BEAULAURIER, ALAINA JORDAN
Entity type:Individual
Prefix:
First Name:ALAINA
Middle Name:JORDAN
Last Name:BEAULAURIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2734 JUNIPER AVE APT 24
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-2448
Mailing Address - Country:US
Mailing Address - Phone:509-389-7643
Mailing Address - Fax:
Practice Address - Street 1:2734 JUNIPER AVE APT 24
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-2448
Practice Address - Country:US
Practice Address - Phone:509-389-7643
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-22
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker