Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | 209016329 | IL |
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 209016329 | IL |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 209016329 | IL |
NPI | 1073030938 |
---|---|
Provider Name | Kathryn Ann Becker |
First Address | Joliet, IL 60435-5002 |
Second Address | Joliet, IL 60435-8200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2017 |
Last Update Date | 26/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
209016329 | ADVANCED PRACTICE NURSE (01) | IL |