Individual
JILL KATRICE BECKWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4750 WATERS AVE, SUITE 202, SAVANNAH, GA 31404-6200
(912) 350-7412
(912) 350-7297
Mailing address
4750 WATERS AVE, SUITE 202, SAVANNAH, GA 31404-6200
(912) 350-7412
(912) 350-7297
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN132814
GA
363LA2200X
Adult Health Nurse Practitioner
Primary
RN132814
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000958075A
—
GA
05
—
000958075C
—
GA
01
—
01376746
AMERIGROUP
GA
01
—
500025280
RR MEDICARE
GA
01
—
567244
WELLCARE
GA
05
—
NP0872
—
SC
01
—
P00903092
RAILROAD MEDICARE
GA
Enumeration date
07/18/2005
Last updated
07/25/2011
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