Provider Demographics
NPI:1235113085
Name:BECKHAM, RUTH H (RN NP)
Entity Type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:H
Last Name:BECKHAM
Suffix:
Gender:F
Credentials:RN NP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9005 GRANT ST
Mailing Address - Street 2:#200
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80229-4300
Mailing Address - Country:US
Mailing Address - Phone:303-287-2800
Mailing Address - Fax:303-287-7357
Practice Address - Street 1:9005 GRANT ST
Practice Address - Street 2:#200
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-4300
Practice Address - Country:US
Practice Address - Phone:303-287-2800
Practice Address - Fax:303-287-7357
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO63736363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO71950087Medicaid
COCC4948OtherMEDICARE PTAN
COCC4948OtherMEDICARE PTAN