Healthcare Provider Details

I. General information

NPI: 1851465439
Provider Name (Legal Business Name): WENDY LEE BECK MSN, RN, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4021 KEITH ST NW
CLEVELAND TN
37312-4341
US

IV. Provider business mailing address

4021 KEITH ST NW
CLEVELAND TN
37312-4341
US

V. Phone/Fax

Practice location:
  • Phone: 423-476-2464
  • Fax: 423-476-1008
Mailing address:
  • Phone: 423-476-2464
  • Fax: 423-476-1008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12291
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: