Healthcare Provider Details

I. General information

NPI: 1285036392
Provider Name (Legal Business Name): FELICIA BECKHAM NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2014
Last Update Date: 09/09/2021
Certification Date: 09/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 SPRINGFIELD PIKE
CINCINNATI OH
45246-4112
US

IV. Provider business mailing address

2123 AUBURN AVE SUITE 401
CINCINNATI OH
45219-2906
US

V. Phone/Fax

Practice location:
  • Phone: 513-782-2448
  • Fax:
Mailing address:
  • Phone: 513-241-5489
  • Fax: 513-241-9206

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRNCNP16561
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCOA 16561 NP
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP.16561
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: