Healthcare Provider Details

I. General information

NPI: 1427161702
Provider Name (Legal Business Name): ROBERT DENNIS BECKMAN CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 H ST
FAIRBURY NE
68352-1119
US

IV. Provider business mailing address

423 W PARK ST
BEATRICE NE
68310-1324
US

V. Phone/Fax

Practice location:
  • Phone: 402-729-3351
  • Fax:
Mailing address:
  • Phone: 308-440-0376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number100423
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: