Provider Demographics
NPI:1184640914
Name:BECKER, ELIZABETH CURRY (CRNA)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:CURRY
Last Name:BECKER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 GREAT PLAIN AVE
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02482-7210
Mailing Address - Country:US
Mailing Address - Phone:508-524-3362
Mailing Address - Fax:
Practice Address - Street 1:99 GREAT PLAIN AVE
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02482-7210
Practice Address - Country:US
Practice Address - Phone:508-524-3362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA074475367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA074475OtherCRNA LICENSE
MABE-NA 1161Medicare ID - Type Unspecified