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NPI Code Detail

MEDICARE: MRS. JENNIFER E. BECKER ARNP

MEDICARE: MRS. JENNIFER E. BECKER ARNP
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
1363LF0000XFamily Nurse PractitionerARNP9165991FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2Y02MBOTHERFLBLUE CROSS BLUE SHIELD
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1972555498
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENNIFER E. BECKER ARNP
Provider Business Mailing Address
First Line : 2995 DREW ST FL 2
Second Line :
City : CLEARWATER
State : FL
Zip : 33759-3012
Country : US
Telephone Number : 727-315-6775
Fax Number :
Provider Business Practice Location Address
First Line : 2727 W DR MARTIN LUTHER KING JR BLVD STE 320
Second Line :
City : TAMPA
State : FL
Zip : 33607-6055
Country : US
Telephone Number : 727-315-6775
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2006
Last Update Date : 08/15/2024

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