Provider Demographics
NPI:1447594684
Name:BECK, KANDACE (DOULA)
Entity Type:Individual
Prefix:
First Name:KANDACE
Middle Name:
Last Name:BECK
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 S MUSTANG RD
Mailing Address - Street 2:#1303
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-0306
Mailing Address - Country:US
Mailing Address - Phone:405-401-8058
Mailing Address - Fax:
Practice Address - Street 1:2000 S MUSTANG RD
Practice Address - Street 2:#1303
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-0306
Practice Address - Country:US
Practice Address - Phone:405-401-8058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-10
Last Update Date:2012-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula