Individual
DR. RANDALL H BECKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DNP, DC, APRN, NP-C
Contact information
Practice address
1433 WELLESLEY CIR, MT PLEASANT, SC 29466-9047
(843) 412-3042
(803) 335-5151
Mailing address
1433 WELLESLEY CIR, MT PLEASANT, SC 29466-9047
(843) 412-3042
(803) 335-5151
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
0905
SC
363LF0000X
Family Nurse Practitioner
Primary
F2945
SC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
F2945
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111635
STATE LICENSE APRN
NE
01
—
2945
SOUTH BOARD OF NURSING LICENSE
SC
01
—
A136003
STATE LICENSE APRN FAMILY NURSE PRACTITIONER
IA
01
—
AA72480281
MEDICARE PTAN
SC
01
—
G136033
STATE LICENSE APRN PSYCH/MENTAL HEALTH
IA
01
—
IB3119001
MEDICARE PTAN
IA
01
—
NA2327003
MEDICARE PTAN
NE
Enumeration date
05/11/2006
Last updated
01/10/2015
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