Healthcare Provider Details

I. General information

NPI: 1386601029
Provider Name (Legal Business Name): JOY E BECKER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 02/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 MAIN ST SUITE 105
NORTHBORO MA
01532-1914
US

IV. Provider business mailing address

112 MAIN ST SUITE 105
NORTHBORO MA
01532-1914
US

V. Phone/Fax

Practice location:
  • Phone: 508-393-7223
  • Fax: 508-393-7026
Mailing address:
  • Phone: 508-393-7223
  • Fax: 508-393-7026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number908092
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberRN90892
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN90892
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: