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General NPI Number Information
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NPI Number | 1508306937
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Entity Type | Individual
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Provider Name | MICHELLE RENE BECKMAN FNP
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Gender | Female
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Dates
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Enumeration Date | 03/04/2017
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Last Update Date | 09/15/2023
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Provider Practice Location Address
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Address Line | 3904 21ST AVE S
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City | MINNEAPOLIS
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State | MN
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Zip | 55407-3070
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Country | US
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Telephone | 507-340-6805
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Fax |
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Provider Business Mailing Address
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Address Line | 3904 21ST AVE S
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City | MINNEAPOLIS
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State | MN
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Zip | 55407-3070
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Country | US
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Telephone | 507-340-6805
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R211615-4
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License Number State | MN
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