Provider Demographics
NPI:1255714531
Name:BECKER, PAMELA JEAN (NP-C)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:JEAN
Last Name:BECKER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2487 S MICHIGAN RD STE E
Mailing Address - Street 2:
Mailing Address - City:EATON RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:48827-8252
Mailing Address - Country:US
Mailing Address - Phone:517-836-2178
Mailing Address - Fax:517-836-2182
Practice Address - Street 1:2487 S MICHIGAN RD STE E
Practice Address - Street 2:
Practice Address - City:EATON RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:48827-8252
Practice Address - Country:US
Practice Address - Phone:517-836-2178
Practice Address - Fax:517-836-2178
Is Sole Proprietor?:No
Enumeration Date:2015-07-03
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704220137363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily