Healthcare Provider Details

I. General information

NPI: 1669097119
Provider Name (Legal Business Name): MELANIE NICOLE BECKHAM RN, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2020
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 3RD ST
MONETT MO
65708-2008
US

IV. Provider business mailing address

PO BOX 100
PIERCE CITY MO
65723-2100
US

V. Phone/Fax

Practice location:
  • Phone: 417-476-1000
  • Fax: 417-943-5540
Mailing address:
  • Phone: 417-476-1000
  • Fax: 417-943-5540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2020012746
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: