Individual
MS. PENNY BECKHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
262 DANNY THOMAS PLACE, MS 0515, C/O DANA CANNON, MEMPHIS, TN 38105-3678
(901) 595-3006
(901) 595-3842
Mailing address
262 DANNY THOMAS PL, MEMPHIS, TN 38105-3678
(901) 595-3006
(901) 595-3842
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
75933
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00126561
—
MS
05
—
010016771
—
VA
05
—
100849790A
—
OK
05
—
104694240
—
MI
05
—
1132730
—
LA
05
—
148279701
—
AR
05
—
167251101
—
TX
05
—
200456220A
—
IN
05
—
2413427
—
OH
05
—
3495434
—
TN
05
—
422400000
—
ME
05
—
915357800
—
MO
05
—
QRN/APN014
—
SC
Enumeration date
06/27/2005
Last updated
04/05/2011
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