Provider Demographics
NPI:1497002976
Name:BECKMAN, PAULA M (LPN)
Entity Type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:M
Last Name:BECKMAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11191 ILLINOIS ROUTE 185
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:IL
Mailing Address - Zip Code:62049-2664
Mailing Address - Country:US
Mailing Address - Phone:217-532-2001
Mailing Address - Fax:217-532-6361
Practice Address - Street 1:11191 ILLINOIS ROUTE 185
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:IL
Practice Address - Zip Code:62049-2664
Practice Address - Country:US
Practice Address - Phone:217-532-2001
Practice Address - Fax:217-532-6361
Is Sole Proprietor?:No
Enumeration Date:2012-08-14
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL043090254164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse