Individual
KATHLEEN ANN BECKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, CNP
Contact information
Practice address
3400 W 66TH ST, SUITE 290, EDINA, MN 55435-2111
(952) 914-1745
Mailing address
1246 PRAIRIE LN, SHAKOPEE, MN 55379-3449
(952) 445-6471
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
R076489-2
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5506204-00
—
MN
Enumeration date
12/30/2005
Last updated
08/05/2011
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