Provider Demographics
NPI:1578236667
Name:BECK, GENIVA MARIE (LPN)
Entity Type:Individual
Prefix:
First Name:GENIVA
Middle Name:MARIE
Last Name:BECK
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 1:5106 NICKEL PLATE DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25705-3134
Mailing Address - Country:US
Mailing Address - Phone:681-306-2677
Mailing Address - Fax:
Practice Address - Street 1:5106 NICKEL PLATE DR
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25705-3134
Practice Address - Country:US
Practice Address - Phone:681-306-2677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV33688164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse