MEDICARE: MINDY LYNN BECK PMHNP-BC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	2023000230	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2023000230	OTHER	AZ	ANCC ID

General Provider Information

NPI Number	:	1265139141
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MINDY LYNN BECK PMHNP-BC

Provider Business Mailing Address
First Line	:	1950 W HEATHERBRAE DR STE 10-1
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85015-5110
Country	:	US
Telephone Number	:	480-708-4125
Fax Number	:	602-336-5160

Provider Business Practice Location Address
First Line	:	1950 W HEATHERBRAE DR STE 10-1
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85015-5110
Country	:	US
Telephone Number	:	480-708-4125
Fax Number	:	602-443-0231

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

Provider Enumeration Date	:	02/13/2023
Last Update Date	:	03/18/2026

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