Provider Demographics
NPI:1710441225
Name:BECK, AGUEDA CRISTINA (CNM)
Entity Type:Individual
Prefix:MS
First Name:AGUEDA
Middle Name:CRISTINA
Last Name:BECK
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1218 EAST 59TH ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31404-6136
Mailing Address - Country:US
Mailing Address - Phone:754-779-3878
Mailing Address - Fax:754-755-3390
Practice Address - Street 1:1218 EAST 59TH ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31404-6136
Practice Address - Country:US
Practice Address - Phone:754-779-3878
Practice Address - Fax:754-755-3390
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-29
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9352045174400000X
FL9352045363LX0001X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No174400000XOther Service ProvidersSpecialist
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL9352045OtherAPRN LINCESE