Provider Demographics
NPI:1184962888
Name:BECKFORD, MILLICENT G (LPN)
Entity type:Individual
Prefix:MS
First Name:MILLICENT
Middle Name:G
Last Name:BECKFORD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 SPINNING WHEEL LN
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33319-2484
Mailing Address - Country:US
Mailing Address - Phone:954-661-6572
Mailing Address - Fax:
Practice Address - Street 1:84 SPINNING WHEEL LN
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33319-2484
Practice Address - Country:US
Practice Address - Phone:954-661-6572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-30
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5205499164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse