Provider Demographics
NPI:1306016860
Name:BECKMANN, NICOLE BETH BRIGGS (NP)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:BETH BRIGGS
Last Name:BECKMANN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:BETH
Other - Last Name:BRIGGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:422 WREN LN
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:WI
Mailing Address - Zip Code:54016-7765
Mailing Address - Country:US
Mailing Address - Phone:919-358-2451
Mailing Address - Fax:
Practice Address - Street 1:2545 CHICAGO AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-4522
Practice Address - Country:US
Practice Address - Phone:612-813-8014
Practice Address - Fax:612-813-5988
Is Sole Proprietor?:No
Enumeration Date:2008-03-11
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI152695163W00000X
WI3372363LP0200X
MNR170994-4163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics