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NPI Code Detail

MEDICARE: THERESA S BECKER APRN

MEDICARE: THERESA S BECKER APRN
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
1363LA2200XAdult Health Nurse Practitioner2147-033WI
2363L00000XNurse Practitioner2147-033WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1295727295
Entity Type Code : Individual
Provider Name (Legal Business Name) : THERESA S BECKER APRN
Provider Business Mailing Address
First Line : 335 MAHN COURT
Second Line :
City : OAK CREEK
State : WI
Zip : 53154
Country : US
Telephone Number : 414-762-2020
Fax Number : 414-762-2024
Provider Business Practice Location Address
First Line : 3120 S 27TH ST FL 2
Second Line :
City : MILWAUKEE
State : WI
Zip : 53215-4338
Country : US
Telephone Number : 414-672-8282
Fax Number : 414-672-8284
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2005
Last Update Date : 12/08/2021

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Directions to “ THERESA S BECKER APRN” Practice Location

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