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General NPI Number Information
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NPI Number | 1356649222
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Entity Type | Individual
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Provider Name | ANDREA NACOLE BECK MS, RD/LD
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Gender | Female
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Dates
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Enumeration Date | 03/02/2011
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Last Update Date | 03/07/2024
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Provider Practice Location Address
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Address Line | 1505 AIRPORT DR
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City | SHAWNEE
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State | OK
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Zip | 74804-4321
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Country | US
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Telephone | 405-273-2202
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Fax | 405-273-2292
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Provider Business Mailing Address
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Address Line | 1505 AIRPORT DR
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City | SHAWNEE
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State | OK
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Zip | 74804-4321
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Country | US
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Telephone | 405-273-2202
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Fax | 405-273-2292
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 1651
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License Number State | OK
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