Provider Demographics
NPI:1164490959
Name:BECKMAN, ALICE A (NNP)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:A
Last Name:BECKMAN
Suffix:
Gender:F
Credentials:NNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2893 NEIL AVE
Mailing Address - Street 2:APT. 400-B
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-2047
Mailing Address - Country:US
Mailing Address - Phone:651-323-7781
Mailing Address - Fax:
Practice Address - Street 1:2893 NEIL AVE
Practice Address - Street 2:APT. 400-B
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43202-2047
Practice Address - Country:US
Practice Address - Phone:651-323-7781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR127675-2363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNP26336Medicare UPIN