Provider Demographics
NPI:1801166509
Name:BECKMAN, ASHLEY ANN (PA)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ANN
Last Name:BECKMAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8005 FARNAM DR
Mailing Address - Street 2:STE 305
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-3426
Mailing Address - Country:US
Mailing Address - Phone:402-390-4111
Mailing Address - Fax:402-399-8455
Practice Address - Street 1:3301 E ELKHORN DR STE 100
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-6240
Practice Address - Country:US
Practice Address - Phone:402-390-4111
Practice Address - Fax:402-390-4115
Is Sole Proprietor?:No
Enumeration Date:2012-01-11
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026130600Medicaid
NE10026130603Medicaid
NE47063010113Medicaid
NE10026130500Medicaid
NE10026130604Medicaid
NEP01631103OtherRAILROAD MEDICARE
NE10026130606Medicaid
NE100258006-00Medicaid
NE10026130602Medicaid
NE10026130605Medicaid
NE10026130605Medicaid
NE099016009Medicare PIN