MEDICARE: REBECCA 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	363LF0000X	Family Nurse Practitioner	201401211NP-PP	OR
2	363LP2300X	Primary Care Nurse Practitioner	NP-1410A	ID
3	363LF0000X	Family Nurse Practitioner	NP-1410A	ID

General Provider Information

NPI Number	:	1982029666
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA BECK NP

Provider Business Mailing Address
First Line	:	2840 S MERIDIAN RD
Second Line	:
City	:	MERIDIAN
State	:	ID
Zip	:	83642-7960
Country	:	US
Telephone Number	:	208-593-6396
Fax Number	:	208-593-6402

Provider Business Practice Location Address
First Line	:	2840 S MERIDIAN RD
Second Line	:
City	:	MERIDIAN
State	:	ID
Zip	:	83642-7960
Country	:	US
Telephone Number	:	208-593-6396
Fax Number	:	208-593-6402

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

Provider Enumeration Date	:	03/04/2014
Last Update Date	:	09/09/2025

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