Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | RN220261 | OH |
NPI | 1265657654 |
---|---|
Provider Name | Mrs. Kathleen Louise Beck |
First Address | Akron, OH 44319-4238 |
Second Address | Akron, OH 44308 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2333040 | (05) | OH |