Individual
CARLY R. BECKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1065 ASHLEY ST STE 200, BOWLING GREEN, KY 42103-3401
(270) 843-3376
(270) 393-2737
Mailing address
201 PARK ST, BOWLING GREEN, KY 42101-1759
(270) 781-3910
(270) 842-7177
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1586
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100200050
—
KY
Enumeration date
12/19/2010
Last updated
01/21/2025
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