Provider Demographics
NPI:1629231808
Name:GARRETT, BEKI E (PA-C)
Entity Type:Individual
Prefix:
First Name:BEKI
Middle Name:E
Last Name:GARRETT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:BEKI
Other - Middle Name:E
Other - Last Name:SWOPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2727 S 144TH ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-5225
Mailing Address - Country:US
Mailing Address - Phone:402-778-5250
Mailing Address - Fax:402-778-5216
Practice Address - Street 1:2727 S 144TH ST
Practice Address - Street 2:SUITE 250
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-5225
Practice Address - Country:US
Practice Address - Phone:402-778-5250
Practice Address - Fax:402-778-5216
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1390363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant