Healthcare Provider Details

I. General information

NPI: 1629231808
Provider Name (Legal Business Name): BEKI E GARRETT PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BEKI E SWOPE

II. Dates (important events)

Enumeration Date: 07/08/2008
Last Update Date: 11/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2727 S 144TH ST SUITE 250
OMAHA NE
68144-5225
US

IV. Provider business mailing address

2727 S 144TH ST SUITE 250
OMAHA NE
68144-5225
US

V. Phone/Fax

Practice location:
  • Phone: 402-778-5250
  • Fax: 402-778-5216
Mailing address:
  • Phone: 402-778-5250
  • Fax: 402-778-5216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1390
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: