Healthcare Provider Details

I. General information

NPI: 1689791105
Provider Name (Legal Business Name): CHERI DELILAH ANN BECK RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

804 ROAD 1349
MOOREVILLE MS
38857-7325
US

IV. Provider business mailing address

804 ROAD 1349
MOOREVILLE MS
38857-7325
US

V. Phone/Fax

Practice location:
  • Phone: 662-844-7942
  • Fax: 662-844-7942
Mailing address:
  • Phone: 662-844-7942
  • Fax: 662-844-7942

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberR824855
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: