Provider Demographics
NPI:1477998540
Name:BECK, CHRISTINE DEIDRE (APRN)
Entity Type:Individual
Prefix:PROF
First Name:CHRISTINE
Middle Name:DEIDRE
Last Name:BECK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W KAWILI ST
Mailing Address - Street 2:UCB 255
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-4075
Mailing Address - Country:US
Mailing Address - Phone:808-933-1138
Mailing Address - Fax:808-974-7665
Practice Address - Street 1:200 W KAWILI ST
Practice Address - Street 2:UH HILO STUDENT MEDICAL SERVICES
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-4075
Practice Address - Country:US
Practice Address - Phone:808-974-7636
Practice Address - Fax:808-933-0868
Is Sole Proprietor?:No
Enumeration Date:2013-05-02
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-1113363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily