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NPI Code Detail

MEDICARE: JESSICA EVA BECK CRNA, APRN

MEDICARE: JESSICA EVA BECK CRNA, 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
1163W00000XRegistered NurseR 208279-6MN
2163W00000XRegistered Nurse170685-30WI
3367500000XCertified Registered Nurse AnesthetistCRNA 1507MN

General Provider Information

NPI Number : 1376932509
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA EVA BECK CRNA, APRN
Provider Business Mailing Address
First Line : 856 WHISPERING PINES CIR
Second Line :
City : LAKE MILLS
State : WI
Zip : 53551-9404
Country : US
Telephone Number : 414-736-9183
Fax Number :
Provider Business Practice Location Address
First Line : 856 WHISPERING PINES CIR
Second Line :
City : LAKE MILLS
State : WI
Zip : 53551-9404
Country : US
Telephone Number : 414-736-9183
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2015
Last Update Date : 02/05/2020

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