Healthcare Provider Details

I. General information

NPI: 1548995756
Provider Name (Legal Business Name): BECK THOMPSON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2022
Last Update Date: 12/10/2024
Certification Date: 12/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4020 RICHARDS RD STE I
NORTH LITTLE ROCK AR
72117-2744
US

IV. Provider business mailing address

PO BOX 497
AUGUSTA AR
72006-0497
US

V. Phone/Fax

Practice location:
  • Phone: 501-916-9693
  • Fax:
Mailing address:
  • Phone: 703-472-5348
  • Fax: 870-301-2092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number219042
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: