Healthcare Provider Details

I. General information

NPI: 1174035166
Provider Name (Legal Business Name): LUTCHANA BECKFORD CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2017
Last Update Date: 06/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 E BROWN ST
EAST STROUDSBURG PA
18301-3006
US

IV. Provider business mailing address

2348 WHITE OAK DR W
EAST STROUDSBURG PA
18301-8379
US

V. Phone/Fax

Practice location:
  • Phone: 570-422-1700
  • Fax:
Mailing address:
  • Phone: 570-807-7452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License NumberRN647633
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN647633
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: