Provider Demographics
NPI:1245057454
Name:BECKETT, EMILY (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:BECKETT
Suffix:
Gender:
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:ANNE
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 20092
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82003-7002
Mailing Address - Country:US
Mailing Address - Phone:307-630-4729
Mailing Address - Fax:
Practice Address - Street 1:1301 RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-4374
Practice Address - Country:US
Practice Address - Phone:970-888-4070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-20
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY55687363L00000X, 363LP0808X
CO1000087363LP0808X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health