Provider Demographics
NPI:1174649370
Name:BECK, ALICIA (FNP)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:BECK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8651 LAKE VILLAGE CIR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37938-4589
Mailing Address - Country:US
Mailing Address - Phone:865-368-8473
Mailing Address - Fax:423-566-5896
Practice Address - Street 1:8651 LAKE VILLAGE CIR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37938-4589
Practice Address - Country:US
Practice Address - Phone:865-368-8473
Practice Address - Fax:423-566-5896
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN11112207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3641385Medicare PIN