Provider Demographics
NPI:1245953926
Name:BECK, NICHOLAS ANDREW (PHARMD)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:ANDREW
Last Name:BECK
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5522 TROOST AVE APT 114
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64110-2801
Mailing Address - Country:US
Mailing Address - Phone:314-276-4797
Mailing Address - Fax:
Practice Address - Street 1:8200 MISSION RD
Practice Address - Street 2:
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66208-5211
Practice Address - Country:US
Practice Address - Phone:913-381-3300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-19
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022036813183500000X
KS1-110003183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist