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NPI Code Detail

MEDICARE: KENNETH BECKER FNP-BC

MEDICARE: KENNETH BECKER FNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner313965AZ

General Provider Information

NPI Number : 1154157873
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENNETH BECKER FNP-BC
Provider Business Mailing Address
First Line : 16165 N 83RD AVE STE 200
Second Line :
City : PEORIA
State : AZ
Zip : 85382-5816
Country : US
Telephone Number : 480-974-1912
Fax Number : 480-400-8763
Provider Business Practice Location Address
First Line : 16165 N 83RD AVE STE 200
Second Line :
City : PEORIA
State : AZ
Zip : 85382-5816
Country : US
Telephone Number : 480-974-1912
Fax Number : 480-400-8763
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/10/2024
Last Update Date : 02/04/2026

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Directions to “ KENNETH BECKER FNP-BC” Practice Location

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