Provider Demographics
NPI:1336107077
Name:BECKEN, AMY KAY (PT)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:KAY
Last Name:BECKEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:35 STATE AVE
Mailing Address - Street 2:
Mailing Address - City:FARIBAULT
Mailing Address - State:MN
Mailing Address - Zip Code:55021-6368
Mailing Address - Country:US
Mailing Address - Phone:507-497-3790
Mailing Address - Fax:507-497-3722
Practice Address - Street 1:35 STATE AVENUE
Practice Address - Street 2:
Practice Address - City:FARIBAULT
Practice Address - State:MN
Practice Address - Zip Code:55021
Practice Address - Country:US
Practice Address - Phone:507-332-0166
Practice Address - Fax:507-332-8069
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6739225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN103183C572OtherUCARE
MN162P0BEOtherBCBS OF MN
MN983181027668OtherPREFERRED ONE
MNHP52474OtherHEALTH PARTNERS
MN6405481OtherMEDICA, MANKATO
MN2350906OtherAMERICA'S PPO
MN6405480OtherMEDICA, FARIBAULT