Provider Demographics
NPI:1922030923
Name:BECK, VIRGINIA A (APRN)
Entity Type:Individual
Prefix:MS
First Name:VIRGINIA
Middle Name:A
Last Name:BECK
Suffix:
Gender:F
Credentials:APRN
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 51014
Mailing Address - Street 2:
Mailing Address - City:ELEELE
Mailing Address - State:HI
Mailing Address - Zip Code:96705-1014
Mailing Address - Country:US
Mailing Address - Phone:808-335-0579
Mailing Address - Fax:808-335-0581
Practice Address - Street 1:4469 WAIALO RD.
Practice Address - Street 2:
Practice Address - City:ELEELE
Practice Address - State:HI
Practice Address - Zip Code:96705
Practice Address - Country:US
Practice Address - Phone:808-335-0579
Practice Address - Fax:808-335-0581
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-181363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI205383OtherHMA
HI50753500OtherALOHACARE
HI00A0232338OtherHMSA
HI99-0232194OtherHMAA
HI50753500Medicaid
HI5263402OtherUHA
HI54101Medicare ID - Type Unspecified