=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245163609
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | GEMMA MAE BECK DACM
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/05/2026
-----------------------------------------------------
Last Update Date | 06/05/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 400 SELBY AVE STE G2
-----------------------------------------------------
City | SAINT PAUL
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55102-4520
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 651-224-6678
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7695 ADDISEN CT
-----------------------------------------------------
City | INVER GROVE
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55077-4550
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 651-757-6865
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | 2143
-----------------------------------------------------
License Number State | MN
-----------------------------------------------------