Healthcare Provider Details

I. General information

NPI: 1639105836
Provider Name (Legal Business Name): ANN BECK ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 S CLIFTON AVE SUITE 201
WICHITA KS
67218-2900
US

IV. Provider business mailing address

1515 S CLIFTON AVE SUITE 201
WICHITA KS
67218-2900
US

V. Phone/Fax

Practice location:
  • Phone: 316-687-9961
  • Fax: 316-687-6561
Mailing address:
  • Phone: 316-687-9961
  • Fax: 316-687-6561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number74313
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: