Provider Demographics
NPI:1356593511
Name:BECKORD, NIKI
Entity type:Individual
Prefix:MS
First Name:NIKI
Middle Name:
Last Name:BECKORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:824 N WISNER ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49202-3141
Mailing Address - Country:US
Mailing Address - Phone:517-782-5724
Mailing Address - Fax:517-782-2057
Practice Address - Street 1:824 N. WISNER ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49202-3949
Practice Address - Country:US
Practice Address - Phone:517-782-5724
Practice Address - Fax:517-782-2057
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3501001375237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist