Provider Demographics
NPI:1558900233
Name:BECKFORD, ATLENA ROSE (FNP)
Entity Type:Individual
Prefix:MS
First Name:ATLENA
Middle Name:ROSE
Last Name:BECKFORD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9103 LITTLE GREEN ST
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-2037
Mailing Address - Country:US
Mailing Address - Phone:301-655-8147
Mailing Address - Fax:
Practice Address - Street 1:9103 LITTLE GREEN ST
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-2037
Practice Address - Country:US
Practice Address - Phone:301-655-8147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-30
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX736454163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice