Provider Demographics
NPI:1679767693
Name:BECK HELWIG, LISA NICOLE (DO)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:NICOLE
Last Name:BECK HELWIG
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:LISA
Other - Middle Name:NICOLE
Other - Last Name:BECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:101 FAIRVIEW CIR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-9581
Mailing Address - Country:US
Mailing Address - Phone:717-279-7303
Mailing Address - Fax:
Practice Address - Street 1:101 FAIRVIEW CIR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-9581
Practice Address - Country:US
Practice Address - Phone:717-279-7303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-03
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS014236207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102336852Medicaid
PA157582Medicare PIN