Individual
LAUREN BREWER BECKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP
Contact information
Practice address
1 LINCOLN PKWY STE 103, HATTIESBURG, MS 39402-3261
(601) 261-1600
Mailing address
30 CIRCLE J DR STE 1, LAUREL, MS 39440-1981
(601) 425-0092
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
22087
TN
363L00000X
Nurse Practitioner
Primary
903381
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08106540
—
MS
01
—
103I505344
PTAN
TN
Enumeration date
11/21/2016
Last updated
11/03/2023
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