MEDICARE: MS. ANNA ROSE BECCONE APRN, FNP-C

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
1	363LF0000X	Family Nurse Practitioner	1010771	TX

General Provider Information

NPI Number	:	1487251765
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANNA ROSE BECCONE APRN, FNP-C

Provider Business Mailing Address
First Line	:	4928 EL CAMPO AVE APT 224
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76107-4909
Country	:	US
Telephone Number	:	817-874-1691
Fax Number	:

Provider Business Practice Location Address
First Line	:	3537 S I 35 E STE 317
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76210-6870
Country	:	US
Telephone Number	:	940-808-0906
Fax Number	:	940-808-0925

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/08/2020
Last Update Date	:	10/19/2020

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