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Individual

JACQUELINE M BECKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
278 VT ROUTE 149, METTOWEE VALLEY FAMILY HEALTH CENTER, WEST PAWLET, VT 05775-9798
(802) 645-0580
(802) 645-0587
Mailing address
278 VT ROUTE 149, METTOWEE VALLEY FAMILY HEALTH CENTER, WEST PAWLET, VT 05775-9798
(802) 645-0580
(802) 645-0587

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1010017766
VT
363L00000X
Nurse Practitioner
F3335321
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01956770
NY
05
ONP1463
VT
Enumeration date
07/21/2006
Last updated
07/08/2007
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