Provider Demographics
NPI:1477679652
Name:ALICIA BECK, FNP, LLC
Entity Type:Organization
Organization Name:ALICIA BECK, FNP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BECK
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:865-368-8473
Mailing Address - Street 1:8651 LAKE VILLAGE CIR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37938-4589
Mailing Address - Country:US
Mailing Address - Phone:865-368-8473
Mailing Address - Fax:423-566-5896
Practice Address - Street 1:8651 LAKE VILLAGE CIR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37938-4589
Practice Address - Country:US
Practice Address - Phone:865-368-8473
Practice Address - Fax:423-566-5896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN11112207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3731237Medicare PIN