Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | R127675-2 | MN |
NPI | 1164490959 |
---|---|
Provider Name | Alice A Beckman |
First Address | Columbus, OH 43202-2047 |
Second Address | Columbus, OH 43202-2047 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2006 |
Last Update Date | 17/08/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P26336 | (02) | MN |