Provider Demographics
NPI:1013651751
Name:BECKNER, TAYLOR PAIGE
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:PAIGE
Last Name:BECKNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:722 VALLEY CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:WV
Mailing Address - Zip Code:26452-8138
Mailing Address - Country:US
Mailing Address - Phone:681-533-3796
Mailing Address - Fax:
Practice Address - Street 1:722 VALLEY CHAPEL RD
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:WV
Practice Address - Zip Code:26452-8138
Practice Address - Country:US
Practice Address - Phone:681-533-3796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-27
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant