Healthcare Provider Details

I. General information

NPI: 1659619161
Provider Name (Legal Business Name): DAVID BRIAN BECK FNP, NP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2013
Last Update Date: 09/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1222 TROTWOOD AVE STE 503
COLUMBIA TN
38401-6422
US

IV. Provider business mailing address

854 W JAMES CAMPBELL BLVD
COLUMBIA TN
38401-4659
US

V. Phone/Fax

Practice location:
  • Phone: 931-490-7775
  • Fax: 931-490-7797
Mailing address:
  • Phone: 931-490-7775
  • Fax: 931-490-7797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number17325
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: