Basic Information
| Provider Information | |||||||||
| NPI: | 1366459265 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BECK | ||||||||
| FirstName: | MARY | ||||||||
| MiddleName: | CLAIRE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | IRWIN ARMY COMMUNITY HOSPITAL, 600 CAISSON HILL RD | ||||||||
| Address2: | ATTN MCXX-CLD-QM (CRED) TERRY HILL | ||||||||
| City: | FORT RILEY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 664425037 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7852397155 | ||||||||
| FaxNumber: | 7852397364 | ||||||||
| Practice Location | |||||||||
| Address1: | IRWIN ARMY COMMUNITY HOSPITAL, 600 CAISSON HILL RD | ||||||||
| Address2: | ATTN MCXX-CLD-QM (CRED) TERRY HILL | ||||||||
| City: | FORT RILEY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 664425037 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7852397155 | ||||||||
| FaxNumber: | 7852397364 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/02/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 45038 | KS | X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LW0102X | 45038 | KS | X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health |
No ID Information.