Healthcare Provider Details

I. General information

NPI: 1982450482
Provider Name (Legal Business Name): EMILEE BECK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2024
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3540 PUMP RD STE 1188
RICHMOND VA
23233-1115
US

IV. Provider business mailing address

3540 PUMP RD STE 1188
RICHMOND VA
23233-1115
US

V. Phone/Fax

Practice location:
  • Phone: 804-404-6270
  • Fax: 804-294-2775
Mailing address:
  • Phone: 804-404-6270
  • Fax: 804-294-2775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: