Provider Demographics
NPI:1851517205
Name:BECKMAN, KARLA D (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MS
First Name:KARLA
Middle Name:D
Last Name:BECKMAN
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 STONE LAKE CT
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN
Mailing Address - State:VA
Mailing Address - Zip Code:23693-3715
Mailing Address - Country:US
Mailing Address - Phone:757-865-9191
Mailing Address - Fax:757-221-1245
Practice Address - Street 1:ONE GOOCH DR.
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23187-8795
Practice Address - Country:US
Practice Address - Phone:757-221-4386
Practice Address - Fax:757-221-1245
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024164693363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0024164693OtherNURSE PRACTITIONER LICENS