Provider Demographics
NPI:1881673887
Name:NESS, BECKY M (PAC)
Entity Type:Individual
Prefix:
First Name:BECKY
Middle Name:M
Last Name:NESS
Suffix:
Gender:F
Credentials:PAC
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Mailing Address - Street 1:1025 MARSH ST
Mailing Address - Street 2:MAYO CLINIC HEALTH SYSTEM
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-4752
Mailing Address - Country:US
Mailing Address - Phone:507-685-4700
Mailing Address - Fax:507-385-5824
Practice Address - Street 1:1025 MARSH ST
Practice Address - Street 2:MAYO CLINIC HEALTH SYSTEM
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-4752
Practice Address - Country:US
Practice Address - Phone:507-685-4700
Practice Address - Fax:507-385-5824
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2020-09-17
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Provider Licenses
StateLicense IDTaxonomies
MN9565363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN0109934OtherMEDICA
MN399A6NEOtherBCBS
970028291OtherRR MEDICARE
MNHP40620OtherHEALTH PARTNERS
MNNA2951032073OtherPREFERRED ONE
MN0120540OtherMEDICA
410849339 56001 C196OtherCHAMPUS
MN142663OtherUCARE
MN1778812OtherAMERICAS PPO
MN124343800Medicaid
MN399A6NEOtherBCBS
MNNA2951032073OtherPREFERRED ONE