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General NPI Number Information
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NPI Number | 1457338337
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Entity Type | Individual
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Provider Name | KATHLEEN ANN BECKMAN RN, CNP
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Gender | Female
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Dates
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Enumeration Date | 12/30/2005
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Last Update Date | 08/05/2011
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Provider Practice Location Address
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Address Line | 3400 W 66TH ST SUITE 290
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City | EDINA
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State | MN
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Zip | 55435-2111
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Country | US
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Telephone | 952-914-1745
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Fax |
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Provider Business Mailing Address
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Address Line | 1246 PRAIRIE LN
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City | SHAKOPEE
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State | MN
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Zip | 55379-3449
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Country | US
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Telephone | 952-445-6471
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | R076489-2
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License Number State | MN
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