Healthcare Provider Details

I. General information

NPI: 1841986114
Provider Name (Legal Business Name): RACHEL BECKMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2023
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 SAN PEDRO DR SE
ALBUQUERQUE NM
87108-5153
US

IV. Provider business mailing address

203 N VAN BUREN AVE
SPRINGFIELD MN
56087-1537
US

V. Phone/Fax

Practice location:
  • Phone: 507-227-2046
  • Fax:
Mailing address:
  • Phone: 507-227-2046
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberT-22008
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: