Healthcare Provider Details

I. General information

NPI: 1316008444
Provider Name (Legal Business Name): ELAINE MARY BECKER CNM, MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 1ST AVE N
GREAT FALLS MT
59401-2606
US

IV. Provider business mailing address

5816 40TH ST SW
GREAT FALLS MT
59404-5011
US

V. Phone/Fax

Practice location:
  • Phone: 406-453-1008
  • Fax: 406-453-2008
Mailing address:
  • Phone: 406-761-4768
  • Fax: 406-453-2008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License NumberRN23136
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: