Organization
MARY BECKER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAROLYN SUMSER MBA (BUSINESS MANAGER)
(502) 896-8660
Entity
Organization
Contact information
Practice address
4121 DUTCHMANS LN, SUITE 101, LOUISVILLE, KY 40207-4707
(502) 896-8660
(502) 896-5863
Mailing address
4121 DUTCHMANS LN, SUITE 101, LOUISVILLE, KY 40207-4707
(502) 896-8660
(502) 896-5863
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
2137P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1952305807
INDIVIDUAL NPI
KY
Enumeration date
02/13/2010
Last updated
01/25/2011
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