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General NPI Number Information
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NPI Number | 1063710093
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Entity Type | Individual
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Provider Name | BECKIE LEIGH VINCENT
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Gender | Female
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Dates
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Enumeration Date | 02/28/2011
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Last Update Date | 02/13/2012
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Provider Practice Location Address
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Address Line | 3311 PRESCOTT RD SUITE 417
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City | ALEXANDRIA
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State | LA
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Zip | 71301-3900
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Country | US
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Telephone | 318-487-1122
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Fax |
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Provider Business Mailing Address
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Address Line | 6049 PEPPER TREE DR
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City | ALEXANDRIA
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State | LA
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Zip | 71303-2196
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Country | US
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Telephone | 318-542-2621
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | AP06457
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License Number State | LA
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