Individual
ANNALISA KAY BECKHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3423 N PROSPECT AVE, SPRINGFIELD, MO 65803-3751
(417) 894-3263
Mailing address
3423 N PROSPECT AVE, SPRINGFIELD, MO 65803-3751
(417) 894-3263
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2012026933
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2012026933
NP LICENSE
MO
Enumeration date
08/03/2012
Last updated
12/21/2021
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