MEDICARE: LORI BECK NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	4704190306	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	5008667510	OTHER	MI	BCBS
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164400917
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORI BECK NP

Provider Business Mailing Address
First Line	:	147 N MILFORD RD
Second Line	:	SUITE 101
City	:	HIGHLAND
State	:	MI
Zip	:	48357-4500
Country	:	US
Telephone Number	:	248-887-3900
Fax Number	:

Provider Business Practice Location Address
First Line	:	147 N MILFORD RD
Second Line	:	SUITE 101
City	:	HIGHLAND
State	:	MI
Zip	:	48357-4500
Country	:	US
Telephone Number	:	248-887-3900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2006
Last Update Date	:	06/25/2015

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Directions to “ LORI BECK NP” Practice Location

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