Provider Demographics
NPI:1942650452
Name:BECKMAN, CRYSTAL DEE (RN BS CDE)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:DEE
Last Name:BECKMAN
Suffix:
Gender:F
Credentials:RN BS CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 W 18TH ST
Mailing Address - Street 2:SANFORD DIABETES CARE CENTER
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-0401
Mailing Address - Country:US
Mailing Address - Phone:605-328-6146
Mailing Address - Fax:605-328-6135
Practice Address - Street 1:1305 W 18TH ST
Practice Address - Street 2:SANFORD DIABETES CARE CENTER
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-0401
Practice Address - Country:US
Practice Address - Phone:605-328-6146
Practice Address - Fax:605-328-6135
Is Sole Proprietor?:No
Enumeration Date:2016-06-15
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SDR024230163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator