Individual
LISA BECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
822 FOREST AVE, PERRY, GA 31069-3726
(478) 972-5003
Mailing address
822 FOREST AVE, PERRY, GA 31069-3726
(478) 972-5003
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN259255
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN259255
LICENSURE
GA
Enumeration date
07/14/2016
Last updated
07/14/2016
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