Provider Demographics
NPI:1013594555
Name:BECK, NATHANIEL W (PHARMD)
Entity Type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:W
Last Name:BECK
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14969 S GREENWOOD ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-3322
Mailing Address - Country:US
Mailing Address - Phone:913-271-5885
Mailing Address - Fax:
Practice Address - Street 1:22350 S HARRISON ST
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:KS
Practice Address - Zip Code:66083-3148
Practice Address - Country:US
Practice Address - Phone:913-592-5350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-29
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-16691183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist