Provider Demographics
NPI:1255055984
Name:BECKER, KIPPY AMY (RN)
Entity type:Individual
Prefix:MS
First Name:KIPPY
Middle Name:AMY
Last Name:BECKER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 N 22ND AVE
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-3901
Mailing Address - Country:US
Mailing Address - Phone:509-543-6798
Mailing Address - Fax:509-546-2854
Practice Address - Street 1:1120 N 22ND AVE
Practice Address - Street 2:
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-3901
Practice Address - Country:US
Practice Address - Phone:509-543-6798
Practice Address - Fax:509-546-2854
Is Sole Proprietor?:No
Enumeration Date:2022-09-27
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60220142163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool