Healthcare Provider Details

I. General information

NPI: 1639242894
Provider Name (Legal Business Name): SHAROLYN KAY BECK MT (ASCP)
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 DOUGLAS ST STOP 0030
OMAHA NE
68179-0030
US

IV. Provider business mailing address

10006 PRATT ST
OMAHA NE
68134-4542
US

V. Phone/Fax

Practice location:
  • Phone: 402-544-3741
  • Fax: 402-501-0475
Mailing address:
  • Phone: 402-571-3263
  • Fax: 402-501-0475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246QM0706X
TaxonomyMedical Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: