MEDICARE: DR. TERESA ROSE BECK N.D.

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	175F00000X	Naturopath	025205 NT00000992	WA

General Provider Information

NPI Number	:	1609296870
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TERESA ROSE BECK N.D.

Provider Business Mailing Address
First Line	:	3311 HICKORY ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68105-2535
Country	:	US
Telephone Number	:	402-933-0439
Fax Number	:

Provider Business Practice Location Address
First Line	:	3311 HICKORY ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68105-2535
Country	:	US
Telephone Number	:	402-933-0439
Fax Number	:

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

Provider Enumeration Date	:	04/25/2014
Last Update Date	:	04/25/2014

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