Provider Demographics
NPI:1811322993
Name:BECKETT, MONICA RENE' (AGACNP)
Entity type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:RENE'
Last Name:BECKETT
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 NAT TURNER BLVD S
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-2899
Mailing Address - Country:US
Mailing Address - Phone:757-596-1900
Mailing Address - Fax:757-591-8560
Practice Address - Street 1:5849 HARBOUR VIEW BLVD
Practice Address - Street 2:SUITE 250
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-3768
Practice Address - Country:US
Practice Address - Phone:757-337-4018
Practice Address - Fax:757-337-4019
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-09
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024171101363LA2100X, 363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology