Healthcare Provider Details

I. General information

NPI: 1265546774
Provider Name (Legal Business Name): VINNIE CURRY BECKLEY RN, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 08/03/2022
Certification Date: 08/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 HAYNES ST
MANCHESTER CT
06040-4131
US

IV. Provider business mailing address

6306 AMBLEWOOD CT
JACKSON MS
39213-7901
US

V. Phone/Fax

Practice location:
  • Phone: 860-533-3494
  • Fax:
Mailing address:
  • Phone: 601-918-6153
  • Fax: 601-981-6320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number902600
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number10704
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: