Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 57.008420 | OH |
Y | 2080P0207X | Pediatric Hematology-Oncologist | 25662 | NE |
NPI | 1205040128 |
---|---|
Provider Name | Jill Catherine Beck |
First Address | Omaha, NE 68198-2168 |
Second Address | Omaha, NE 68198-2168 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2007 |
Last Update Date | 23/06/2010 |