Provider Demographics
NPI:1922026384
Name:BECK, LAURA FAYE (CRNA)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:FAYE
Last Name:BECK
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1321 LADY STREET 1ST FLOOR
Mailing Address - Street 2:PALMETTO HEALTH RICHLAND
Mailing Address - City:COULMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203
Mailing Address - Country:US
Mailing Address - Phone:803-296-2548
Mailing Address - Fax:803-296-2525
Practice Address - Street 1:3301 HARDEN ST EXT 5 MEDICAL PARK
Practice Address - Street 2:PALMETTO HEALTH RICHLAND
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203
Practice Address - Country:US
Practice Address - Phone:803-296-2548
Practice Address - Fax:803-296-2525
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC2096367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered