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NPI Code Detail

MEDICARE: EMILY JANE BECKER PAC

MEDICARE:   EMILY JANE BECKER  PAC
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
1363AM0700XMedical Physician Assistant2310CO

General Provider Information

NPI Number : 1255417697
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY JANE BECKER PAC
Provider Business Mailing Address
First Line : 7180 E ORCHARD RD
Second Line : SUITE 208A
City : CENTENNIAL
State : CO
Zip : 80111-1724
Country : US
Telephone Number : 303-740-0998
Fax Number :
Provider Business Practice Location Address
First Line : 7180 E ORCHARD RD
Second Line : SUITE 208A
City : CENTENNIAL
State : CO
Zip : 80111-1724
Country : US
Telephone Number : 303-740-0998
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2006
Last Update Date : 03/20/2014

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Directions to “ EMILY JANE BECKER PAC” Practice Location

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