Provider Demographics
NPI:1851802250
Name:BECKER, MEGAN CHRISTINE (ARNP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:CHRISTINE
Last Name:BECKER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 945921
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30394-5921
Mailing Address - Country:US
Mailing Address - Phone:352-742-1171
Mailing Address - Fax:
Practice Address - Street 1:801 E DIXIE AVE
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-7699
Practice Address - Country:US
Practice Address - Phone:352-742-1171
Practice Address - Fax:352-742-7241
Is Sole Proprietor?:No
Enumeration Date:2017-10-12
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9308689163W00000X
FLARNP9308689363LG0600X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP9308689OtherSTATE MEDICAL LICENSE