Provider Demographics
NPI:1760521280
Name:BECK, SAMUEL LEWIS (FNP-C)
Entity Type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:LEWIS
Last Name:BECK
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:538 SCOTTS CREEK RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-5281
Mailing Address - Country:US
Mailing Address - Phone:828-586-8994
Mailing Address - Fax:828-586-8994
Practice Address - Street 1:538 SCOTTS CREEK RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SYLVA
Practice Address - State:NC
Practice Address - Zip Code:28779-5281
Practice Address - Country:US
Practice Address - Phone:828-586-8994
Practice Address - Fax:828-586-8994
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21002363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC21002OtherFNP-C