Provider Demographics
NPI:1932272721
Name:BECKLER, LAVONNE FAYE (ADULT NURSE PRACTITI)
Entity Type:Individual
Prefix:MS
First Name:LAVONNE
Middle Name:FAYE
Last Name:BECKLER
Suffix:
Gender:F
Credentials:ADULT NURSE PRACTITI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CBHH- FERGUS FALLS,1801 W ALCOTT AVE
Mailing Address - Street 2:
Mailing Address - City:FERGUS FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56537-0478
Mailing Address - Country:US
Mailing Address - Phone:218-332-5001
Mailing Address - Fax:218-739-1329
Practice Address - Street 1:CBHH- FERGUS FALLS,1801 W ALCOTT AVE
Practice Address - Street 2:
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56537-0478
Practice Address - Country:US
Practice Address - Phone:218-332-5001
Practice Address - Fax:218-739-1329
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR068756-2363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health