Healthcare Provider Details
I. General information
NPI: 1649192311
Provider Name (Legal Business Name): BECKY NEEDHAM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2883 COUNTY ROAD 301
PARACHUTE CO
81635-9117
US
IV. Provider business mailing address
2883 COUNTY ROAD 301
PARACHUTE CO
81635-9117
US
V. Phone/Fax
- Phone: 970-319-4087
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163WE0003X |
| Taxonomy | Emergency Registered Nurse |
| License Number | RN.0186377 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: