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NPI Code Detail

MEDICARE: PAULETTE L BECKER NP-C

MEDICARE: PAULETTE L BECKER NP-C
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
1363LF0000XFamily Nurse PractitionerNP0871055OH

General Provider Information

NPI Number : 1174724777
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAULETTE L BECKER NP-C
Provider Business Mailing Address
First Line : PO BOX 339
Second Line :
City : ENON
State : OH
Zip : 45323-0339
Country : US
Telephone Number : 937-864-7363
Fax Number : 937-864-5895
Provider Business Practice Location Address
First Line : 7790 DAYTON SPRINGFIELD RD
Second Line : SUITE B
City : FAIRBORN
State : OH
Zip : 45324-1957
Country : US
Telephone Number : 937-864-7363
Fax Number : 937-864-5895
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2007
Last Update Date : 10/07/2010

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Directions to “ PAULETTE L BECKER NP-C” Practice Location

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