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NPI Code Detail

MEDICARE: MRS. KATHLEEN BECK

MEDICARE: MRS. KATHLEEN BECK
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
1164W00000XLicensed Practical NurseLPNAZ

General Provider Information

NPI Number : 1396836813
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KATHLEEN BECK
Provider Business Mailing Address
First Line : 1226 W OSBORN RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85013-3618
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1226 W OSBORN RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85013-3618
Country : US
Telephone Number : 999-999-9999
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2006
Last Update Date : 10/14/2014

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Directions to “ MRS. KATHLEEN BECK ” Practice Location

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