Provider Demographics
NPI:1891915153
Name:BECK-SIEG, JUDY HENSLEY (ANRN, BC (NP))
Entity Type:Individual
Prefix:MS
First Name:JUDY
Middle Name:HENSLEY
Last Name:BECK-SIEG
Suffix:
Gender:F
Credentials:ANRN, BC (NP)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2349 BRANDT VLG
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27455-2169
Mailing Address - Country:US
Mailing Address - Phone:336-286-0976
Mailing Address - Fax:
Practice Address - Street 1:REGIONAL CANCER CENTER
Practice Address - Street 2:501 NORTH ELAM AVE
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27403-1199
Practice Address - Country:US
Practice Address - Phone:336-832-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC045101363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP83806Medicare UPIN